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Efficacy of the Da Vinci Robot Versus Thoracoscopic Surgery for Patients with Mediastinal Tumors of Different Body Mass Index: a Multicenter Propensity Score-matched Study

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Publisher Biomed Central
Date 2024 Sep 28
PMID 39342280
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Abstract

Background: The purpose of the present study was to evaluate the efficacy and safety of da Vinci robot-assisted thoracoscopic surgery (RATS) versus video-assisted thoracoscopic surgery (VATS) for the treatment of patients with mediastinal tumors of different body mass indices (BMI).

Methods: A retrospective cohort study was used to collect 260 patients with mediastinal tumors admitted to three medical centers in China from December 2020 to March 2024. These patients underwent mediastinal tumor resection by RATS (n = 125) or VATS (n = 135). Propensity score matching (PSM) analysis was performed for the both groups, and further, the patients were divided into the N-BMI group (18.5 kg/m ≤ BMI < 25 kg/m) and the H-BMI group (BMI ≥ 25 kg/m) based on their BMI to compare patients' surgery-related information.

Results: The RATS group had more advantages than the VATS group in terms of intraoperative blood loss, total postoperative drainage, postoperative drainage time, and postoperative hospital stay. As for hospitalization costs, the VATS group was more advantageous. In the H-BMI group, subgroup analysis showed a statistically significant difference in shorter operative time and lower incidence of postoperative complications in the RATS group.

Conclusion: RATS has technical and short-term efficacy advantages in comparison with VATS, although it has the drawback of high costs associated with the treatment of mediastinal tumors. In the patients with mediastinal tumors of H-BMI, RATS can achieve better short-term outcomes and safety, especially in the reduction of the incidence of postoperative complications.

References
1.
Valentijn T, Galal W, Tjeertes E, Hoeks S, Verhagen H, Stolker R . The obesity paradox in the surgical population. Surgeon. 2013; 11(3):169-76. DOI: 10.1016/j.surge.2013.02.003. View

2.
Alvarado C, Worrell S, Bachman K, Jiang B, Janko M, Gray K . Robotic Approach Has Improved Outcomes for Minimally Invasive Resection of Mediastinal Tumors. Ann Thorac Surg. 2021; 113(6):1853-1858. DOI: 10.1016/j.athoracsur.2021.05.090. View

3.
Xu H, Fan F, Gong Y, Jing X, Lin X, Wang H . Diagnostic Challenges in Fine-Needle Aspiration Cytology of Mediastinal Tumors and Lesions. Arch Pathol Lab Med. 2021; 146(8):960-974. DOI: 10.5858/arpa.2021-0108-RA. View

4.
Li X, Cong Z, Xu Y, Zhou H, Wu W, Wang G . Clinical efficacy of robot-assisted thoracoscopic surgery for posterior mediastinal neurogenic tumors. J Thorac Dis. 2020; 12(6):3065-3072. PMC: 7330773. DOI: 10.21037/jtd-20-286. View

5.
Hong Z, Gou W, Cui B, Sheng Y, Bai X, Jin D . Analysis of the efficacy of the da Vinci robot in surgery for posterior mediastinal neurogenic tumors. BMC Surg. 2022; 22(1):413. PMC: 9724356. DOI: 10.1186/s12893-022-01855-x. View