{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:40:41Z","timestamp":1791463241983,"version":"4.3.4"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,24]],"date-time":"2021-09-24T00:00:00Z","timestamp":1632441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Robotics Computer Surgery"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recently, thymectomy using minimally invasive approaches has been increasing with the development of robotic video\u2010assisted thoracoscopic surgery (R\u2010VATS). Although multimodal approach is effective for robot assisted thymectomy, it is necessary to determine the approach (left, right or subxiphoid) associated with the least complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An electronic retrieval from PubMed, Embase, Web of Science, GreyNet International and The Cochrane Library. The single\u2010arm meta\u2010analysis was performed to compare the rate of complications of right\u2010 and left\u2010side approaches by R\u2010VATS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 21 studies including 930 patients were identified. The pooled incidence of total complications was 12.2% (confidence interval: 10.0%\u201314.8%) for all studies. The overall complication rate was 17.3% for the right\u2010side compared with 7.4% for the left side (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, odds ratio\u00a0=\u00a02.484, 1.601\u20133.852). The pooled incidence of air leak was significantly higher for the right versus left side (5.1% vs. 1.2%, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004). The incidence of atrial fibrillation was higher for the right\u2010side compared with the left\u2010side approach (4% vs. 1.2%, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004). The open conversion rate was significantly higher for the right versus the left\u2010side (6.5% vs. 2.9%, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.004). However, there was no significant difference in the pooled incidence of pleural effusion and thoracic duct fistula when comparing the right\u2010 and left\u2010side approaches. In subgroup analysis, in the left approach, the incidence of overall complications (28.6% vs. 5.5%, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002) and pleural effusion (14.3% vs. 1%, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002) was higher for the \u2018Old Age\u2019 group compared with the \u2018Youth\u2019 group; However, In the subgroup analysis of gender, there was no significant difference in the incidence of complications after thymectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Robotic video\u2010assisted thoracoscopic surgery can be performed on the left\u2010 and right\u2010sides; however, complications are minimal with the left\u2010side approach. These data demonstrate that the incidence of overall complications, atrial fibrillation, open conversion ratios, and air leak rate of left\u2010side R\u2010VATS thymectomy are lower than those of right\u2010side. Further subgroup analysis showed that the incidence of postoperative complications was higher in the older group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/rcs.2333","type":"journal-article","created":{"date-parts":[[2021,9,17]],"date-time":"2021-09-17T15:33:54Z","timestamp":1631892834000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Complications of robot\u2010assisted thymectomy: A single\u2010arm meta\u2010analysis and systematic review"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0478-5215","authenticated-orcid":false,"given":"Jia\u2010Xin","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Cardio\u2010Thoracic surgery Institute of Yan'an Hospital Affiliated to Kunming Medical University  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Qian","sequence":"additional","affiliation":[{"name":"Faculty of Life and Biotechnology Institute of Kunming University of Science and Technology  Kunming China"},{"name":"Department of Thoracic Surgery Institute of the First People's Hospital of Yunnan Province  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Deng","sequence":"additional","affiliation":[{"name":"Faculty of Life and Biotechnology Institute of Kunming University of Science and Technology  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010Yan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Regenerative Medicine Research Center Institute of the First People's Hospital of Yunnan Province  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Mei","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Institute of the First People's Hospital of Yunnan Province  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[{"name":"Regenerative Medicine Research Center Institute of the First People's Hospital of Yunnan Province  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Hong","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Institute of the First People's Hospital of Yunnan Province  Kunming China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,24]]},"reference":[{"issue":"3","key":"e_1_2_8_2_1","first-page":"376","article-title":"Comparative study of video\u2010assisted thoracoscopic surgery versus open thymectomy for thymoma and myasthenia gravis","volume":"13","author":"Er\u015fen E","year":"2018","journal-title":"Wideochir Inne Tech Maloinwazyjne"},{"issue":"7","key":"e_1_2_8_3_1","first-page":"453","article-title":"[Perioperative outcomes and long\u2010term survival in clinically early\u2010stage thymic malignancies: video\u2010assisted thoracoscopic thymectomy versus open approaches]","volume":"19","author":"Wang H","year":"2016","journal-title":"Zhongguo Fei Ai Za Zhi"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/jovs.2017.05.01"},{"issue":"1","key":"e_1_2_8_5_1","first-page":"124","article-title":"Left\u2010 and right\u2010sided video\u2010assisted thoracoscopic thymectomy exhibit similar effects on myasthenia gravis","volume":"8","author":"Xie X","year":"2016","journal-title":"J Thorac 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