Subxiphoid thymectomy is a novel alternative to the transthoracic approach and sternotomy, with potential benefits, such as reduced postoperative pain and faster recovery. We previously reported the initial experience with subxiphoid single-port robotic-assisted thoracic surgery (SRATS) thymectomy using the single-port robotic system (SPS). However, the efficacy of this technique remains unknown. Thus, this study examined the multi-institutional experience with SRATS thymectomy and compared the perioperative outcomes of this technique to those of subxiphoid single-port video-assisted thoracic surgery (SVATS) thymectomy. The data of patients who underwent subxiphoid SRATS and SVATS thymectomy, performed by three thoracic surgeons at three institutions between September 2018 and May 2024, were retrospectively collected. In total, 110 patients were included, with 85 and 25 undergoing SRATS and SVATS thymectomy, respectively. After propensity score matching, 25 patients were included in each group. The SRATS group was associated with a lower conversion rate to multi-port surgery (0% vs. 20%,p= 0.05), shorter chest tube drainage duration (1.32 ± 0.75 vs. 2.00 ± 1.29 days,p= 0.003), and a shorter postoperative hospital stay (2.52 ± 1.00 vs. 5.08 ± 5.20 days,p= 0.003). Subxiphoid SRATS thymectomy using the SPS is feasible and is a good alternative to conventional thymectomy. Further studies are necessary to confirm its benefits.
剑突下单孔机器人辅助胸腺切除术是经胸入路和胸骨切开术的一种新型替代方法，具有减轻术后疼痛和加快恢复等潜在优势。我们先前报道了使用单孔机器人系统进行剑突下单孔机器人辅助胸腺切除术的初步经验，但该技术的疗效尚不明确。因此，本研究回顾性收集了2018年9月至2024年5月期间，由三家医疗机构的3位胸外科医师实施的剑突下单孔机器人辅助胸腺切除术与剑突下单孔胸腔镜胸腺切除术患者的临床资料，旨在探讨多中心应用单孔机器人辅助胸腺切除术的经验，并比较该技术与剑突下单孔胸腔镜胸腺切除术的围手术期结果。共纳入110例患者，其中85例接受单孔机器人辅助胸腺切除术，25例接受单孔胸腔镜胸腺切除术。经倾向评分匹配后，每组各纳入25例患者。结果显示，单孔机器人辅助胸腺切除术组中转多孔手术率更低（0% vs. 20%，p=0.05），胸腔引流管留置时间更短（1.32±0.75天 vs. 2.00±1.29天，p=0.003），术后住院时间更短（2.52±1.00天 vs. 5.08±5.20天，p=0.003）。研究表明，采用单孔机器人系统实施剑突下单孔机器人辅助胸腺切除术具有可行性，是传统胸腺切除术的良好替代方案，但其优势仍需进一步研究验证。
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