{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T11:11:39Z","timestamp":1788174699142,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"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":["Thoracic Cancer"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to evaluate the safety and effectiveness of robot\u2010assisted thymectomy (RAT) in large anterior mediastinal tumors (AMTs) (size \u22656\u00a0cm) compared with video\u2010assisted thymectomy (VAT) and open surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 132 patients with large AMTs who underwent surgical resection from January 2016 to June 2022 were included in this study. A total of 61 patients underwent RAT, 36 patients underwent VAT and 35 patients underwent open surgery. Perioperative outcomes were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in tumor size (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.141), or pathological types (<jats:italic>p<\/jats:italic>\u00a0=\u20090.903). Compared with the open group, the RAT and VAT groups were associated with a shorter operation time (115.00 vs. 160.00, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.012; 122.50 vs. 160.00, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.071), and less blood loss (50.00 vs. 200.00, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; 50.00 vs. 200.00, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), respectively. The rate of conversion in the RAT group was similar to that in the VAT group (6.56% vs. 13.89%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.229). Concomitant resection was less frequently performed in the VAT group than in the RAT and open groups (5.56% vs. 31.15%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.040; 5.56% vs. 31.43%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.006). VAT patients had a lower drainage volume (365.00 vs. 700.00 and 910.00\u2009mL, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), shorter duration of chest tube (2.00 vs. 3.00 and 4.00, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and shorter hospital stay (5.00 vs. 6.00 and 7.00, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than the RAT and open groups. There was no 30\u2010day mortality in any group. No difference was seen in R0 resection rates (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.846). The postoperative complication rates were similar among the three groups (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.309). Total in\u2010hospital costs (66493.90 vs. 33581.05 and 42876.40, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were significantly higher in the RAT group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RAT is safe and effective for the resection of large AMTs compared to VAT and open surgery. Vascular resection in RAT is technically feasible. A long\u2010term follow\u2010up is required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.14744","type":"journal-article","created":{"date-parts":[[2022,11,26]],"date-time":"2022-11-26T14:25:58Z","timestamp":1669472758000},"page":"267-273","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Robot\u2010assisted thymectomy in large anterior mediastinal tumors: A comparative study with video\u2010assisted thymectomy and open surgery"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1753-4290","authenticated-orcid":false,"given":"Bin","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qun\u2010You","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Daping Hospital (Army Medical Center of Chinese People's Liberation Army) Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3217-143X","authenticated-orcid":false,"given":"Bo","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Daping Hospital (Army Medical Center of Chinese People's Liberation Army) Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long\u2010Yong","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Daping Hospital (Army Medical Center of Chinese People's Liberation Army) Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3136-8380","authenticated-orcid":false,"given":"Yi\u2010Dan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5168-5554","authenticated-orcid":false,"given":"Long\u2010Fei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Daping Hospital (Army Medical Center of Chinese People's Liberation Army) Army Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00350-6"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.04.037"},{"key":"e_1_2_8_4_1","first-page":"1","article-title":"Minimally invasive versus open thymectomy: a systematic review of surgical techniques, patient demographics, and perioperative outcomes","volume":"5","author":"Hess NR","year":"2016","journal-title":"Ann Cardiothorac 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