robot-assisted vs vats for thymoma

Conditions: Thymoma

Summary: the aim of this study is to explore the advantages of robot-assisted thymectomy in long-term survival benefits and short-term clinical efficacy compared with video-assisted thoracoscopic thymectomy based on a multi-center, prospective, randomized controlled clinical trial.

video-assisted thoracoscopic surgery ( vats ) is widely used in thoracic surgery and has gradually replaced traditional thoracotomy in thymoma. as a new type of vats, the long-term oncological results of robot-assisted thoracoscopic surgery in thymoma have not been verified. therefore, we designed a multicenter, prospective, randomized controlled clinical trial to determine whether rats thymectomy is as effective as vats thymectomy in terms of short-term and long-term outcomes.

Eligibility criteria:
inclusion criteria: 1. ) the age of the subjects on the day of signing the informed consent was ≥ 18 years old and \< 75 years old, regardless of gender ; 2. ) chest thin-layer ct and mr showed anterior mediastinal space-occupying lesions, combined with relevant hematological indicators, the patient was clinically diagnosed as a thymic epithelial tumor with or without myasthenia gravis ( mg ) symptoms. 3. ) need to accept thymectomy surgery ; 4. ) clinical stage i to iiia ( ajcc-uicc tnm staging system ) ; 5. ) the maximum diameter of the lesion \< 5cm ; 6. ) physical condition score 0 or 1 ( eastern cooperative oncology group ecog scoring system ) ; 7. ) have not received any anti-thymoma therapy before, including but not limited to systemic chemotherapy, radiotherapy, etc. ; 8. ) preoperative major organ function meets the following criteria : bone marrow function: hemoglobin ≥ 10.0 g / dl ( no blood transfusion within 28 days before hemoglobin examination ), absolute neutrophil count ≥ 1.5 × 109 / l, platelet count ≥ 100 × 109 / l ( no transfusion of apheresis platelets or il-11 treatment within 14 days before platelet count examination ) ; coagulation function : inr and pt \< 1.5 × uln, aptt ≤ 1.5 × uln ; liver function: transaminase ( alt and ast ) ≤ 2.5 × uln; total bilirubin ≤ 1.5 × uln ( gilbert's syndrome or liver metastasis subjects total bilirubin ≤ 2.5 × uln ) ; renal function: serum creatinine clearance rate ≥ 60 ml/min ( calculated according to the cockcroft-gault formula ) ; 9. ) voluntarily participated in and were able to undergo robot-assisted or thoracoscopic thymectomy, and complied with the study follow-up plan. exclusion criteria: 1. ) patients with myasthenia gravis crisis ; 2. ) had undergone mediastinal surgery or cardiac surgery ; 3. ) body mass index ( bmi ) ≥ 30 ; 4. ) patients with severe liver and kidney dysfunction ( alt and/or ast more than three times the upper limit of normal, cr more than the upper limit of normal ) ; 5. ) combined with severe chronic lung diseases such as copd, asthma, or interstitial lung disease ; 6. ) suffering from uncontrolled heart, kidney, gastrointestinal, and infectious diseases and other complications ; 7. ) patients with other malignant tumors or hematological diseases ; 8. ) combined with chronic pain or preoperative use of opioid analgesics ; 9. ) patients with thoracic deformity or combined with pectus carinatum and pectus excavatum ; 10. ) have mental disorders, such as anxiety disorders ; 11. ) pregnant and/or lactating women ; 12. ) is currently participating in other interventional clinical studies.