{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:11:20Z","timestamp":1787508680758,"version":"build-2736575974"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82372855"],"award-info":[{"award-number":["82372855"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82072557"],"award-info":[{"award-number":["82072557"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Interdisciplinary Program of Shanghai Jiao Tong University","award":["YG2023ZD04"],"award-info":[{"award-number":["YG2023ZD04"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Video-assisted thoracic surgery (VATS) and robot-assisted thoracic surgery (RATS) are widely used in the treatment of anterior mediastinal lesions. However, recent reports comparing the efficacy of VATS and RATS remain unclear, owing to limitations, including territorial constraints, small sample sizes or lack of subgroup analysis. Thus, we conducted a multi-centre retrospective study to compare perioperative outcomes of VATS and RATS via lateral thoracic or subxiphoid approach for anterior mediastinal lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients with anterior mediastinal lesions from 3 high-volume Chinese centres were included. VATS and RATS via lateral thoracic or subxiphoid approaches were performed. A propensity score-matching analysis was conducted with covariates including sex, smoking, alcohol, hypertension, diabetes, myasthenia gravis symptoms, lesion diameter, pathology and blood test results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 1076 patients (954 VATS, 122 RATS) were included. For the lateral thoracic approach, 122 VATS and 62 RATS patients were matched. RATS resulted in shorter catheter retention (P\u2009&amp;lt;\u20090.001), shorter postoperative stays (P\u2009=\u20090.002) and lower complication rates (P\u2009&amp;lt;\u20090.001), with no conversions or re-surgeries. For the subxiphoid approach, 98 VATS and 52 RATS patients were matched. RATS demonstrated higher drainage volume (P\u2009&amp;lt;\u20090.001), longer catheter retention (P\u2009=\u20090.03) and greater albumin reduction (P\u2009&amp;lt;\u20090.001), with no conversions or re-surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Using the lateral thoracic approach, RATS offered shorter catheter retention, shorter postoperative stays and fewer complications. However, with the subxiphoid approach, RATS led to higher drainage volume and longer catheter retention. Our study indicates that surgical approach impacts outcomes, with RATS being more beneficial for lateral thoracic cases and VATS for subxiphoid cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaf113","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T08:04:13Z","timestamp":1746086653000},"source":"Crossref","is-referenced-by-count":2,"title":["Comparison between robot- and video-assisted thoracoscopic surgeries for anterior mediastinal lesions"],"prefix":"10.1093","volume":"67","author":[{"given":"Yeke","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xipeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yajie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqin","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjiu","family":"Gou","sequence":"additional","affiliation":[{"name":"First Department of Thoracic Surgery, Gansu Provincial Hospital , Lanzhou,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shumin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Northern Theater General Hospital , Shenyang,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8069-6033","authenticated-orcid":false,"given":"Hecheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,5]]},"reference":[{"key":"2025061004215198400_ezaf113-B1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s11604-020-01031-2","article-title":"Anterior mediastinal lesions: CT and MRI features and differential diagnosis","volume":"39","author":"Nakazono","year":"2021","journal-title":"Jpn J Radiol"},{"key":"2025061004215198400_ezaf113-B2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1055\/s-0034-1396594","article-title":"Long-term outcome for early stage thymoma: comparison between thoracoscopic and open approaches","volume":"63","author":"Maniscalco","year":"2015","journal-title":"Thorac Cardiovasc Surg"},{"key":"2025061004215198400_ezaf113-B3","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.jtcvs.2010.09.003","article-title":"Comparison of surgical techniques for early-stage thymoma: feasibility of minimally invasive thymectomy and comparison with open resection","volume":"141","author":"Pennathur","year":"2011","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025061004215198400_ezaf113-B4","doi-asserted-by":"crossref","first-page":"3840","DOI":"10.21037\/jtd-23-377","article-title":"Robot-assisted thoracic surgery versus video-assisted thoracic surgery for mediastinal lesions","volume":"15","author":"Ochi","year":"2023","journal-title":"J Thorac Dis"},{"key":"2025061004215198400_ezaf113-B5","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1093\/icvts\/ivab112","article-title":"Comparison between robot-assisted thoracoscopic surgery and video-assisted thoracoscopic surgery for mediastinal and hilar lymph node dissection in lung cancer surgery","volume":"33","author":"Haruki","year":"2021","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2025061004215198400_ezaf113-B6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.21037\/med-20-56","article-title":"Comparison of surgical outcomes after robotic assisted thoracic surgery, video-assisted thoracic surgery and open resection of thymoma","volume":"5","author":"El-Akkawi","year":"2021","journal-title":"Mediastinum"},{"key":"2025061004215198400_ezaf113-B7","doi-asserted-by":"crossref","first-page":"174","DOI":"10.21037\/acs.2019.02.04","article-title":"A systematic review of robotic versus open and video assisted thoracoscopic surgery (VATS) approaches for thymectomy","volume":"8","author":"O'Sullivan","year":"2019","journal-title":"Ann Cardiothorac Surg"},{"key":"2025061004215198400_ezaf113-B8","journal-title":"Int J Med Robotics Comput Assist Surg"},{"key":"2025061004215198400_ezaf113-B9","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/imi.0000000000000382","article-title":"Video-Assisted Thoracoscopic Versus Robotic-Assisted Thoracoscopic Thymectomy: Systematic Review and Meta-analysis","volume":"12","author":"Fok","year":"2017","journal-title":"Innovations (Phila)"},{"key":"2025061004215198400_ezaf113-B10","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.21037\/jtd.2017.06.09","article-title":"A comparison of three approaches for the treatment of early-stage thymomas: robot-assisted thoracic surgery, video-assisted thoracic surgery, and median sternotomy","volume":"9","author":"Qian","year":"2017","journal-title":"J Thorac Dis"},{"key":"2025061004215198400_ezaf113-B11","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/1477-7819-11-157","article-title":"Video-assisted thoracoscopic surgery versus robotic-assisted thoracoscopic surgery in the surgical treatment of Masaoka stage I thymoma","volume":"11","author":"Ye","year":"2013","journal-title":"World J Surg Oncol"},{"key":"2025061004215198400_ezaf113-B12","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.thorsurg.2010.02.002","article-title":"Surgical approaches for invasive tumors of the anterior mediastinum","volume":"20","author":"D\u2019Andrilli","year":"2010","journal-title":"Thorac Surg Clin"},{"key":"2025061004215198400_ezaf113-B13","first-page":"S265","article-title":"Thymectomy via a subxiphoid approach: single-port and robot-assisted","volume":"8","author":"Suda","year":"2016","journal-title":"J Thorac Dis."},{"key":"2025061004215198400_ezaf113-B14","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1089\/lap.2023.0124","article-title":"A Propensity Score-Matching Analysis: Robotic Thymectomy Through the Subxiphoid Has Advantages Over Video-Assisted Thymectomy Surgery","volume":"33","author":"Chendaer","year":"2023","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"2025061004215198400_ezaf113-B15","doi-asserted-by":"crossref","first-page":"984043","DOI":"10.3389\/fsurg.2022.984043","article-title":"Clinical analysis of subxiphoid vs. lateral approaches for treating early anterior mediastinal thymoma","volume":"9","author":"Li B, Niu L, Gu C","year":"2022","journal-title":"Front Surg"},{"key":"2025061004215198400_ezaf113-B16","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1186\/s12957-024-03325-5","article-title":"Meta-analysis of clinical efficacy of thoracoscopy and robotic surgery in the treatment of mediastinal tumors","volume":"22","author":"Dang","year":"2024","journal-title":"World J Surg Onc"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/advance-article-pdf\/doi\/10.1093\/ejcts\/ezaf113\/63054874\/ezaf113.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/67\/5\/ezaf113\/63054874\/ezaf113.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/67\/5\/ezaf113\/63054874\/ezaf113.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T04:46:57Z","timestamp":1749530817000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezaf113\/8125023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5,6]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezaf113","relation":{},"ISSN":["1873-734X"],"issn-type":[{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2025,5]]},"article-number":"ezaf113"}}