title: Robotic extended thymectomy for early-stage thymomas.
abstract: OBJECTIVE
  The aim of this study was to report a single referral centre experience in robotic extended thymectomy for clinical early-stage thymomas, evaluating its safety, feasibility and efficacy, with special regard to oncological outcomes.
  
  
  METHODS
  Between April 2002 and February 2011, we retrospectively selected all those patients who underwent robotic thymectomy for clinical early-stage thymomas. Operative time, morbidity, mortality, duration of hospitalization and overall and disease-free survival were analysed.
  
  
  RESULTS
  There were 14 patients (8 males, 6 females) with a mean age of 65.2 years (range 23-81). One patient suffered from myasthenia gravis. The WHO classifications were: A in two cases, AB in four cases, B1 in three cases, B2 in two cases and B3 in three cases. The Masaoka stages were: I in seven cases, IIA in four cases, IIB in two cases and III in one case. The mean operative time was 139 min. No intra-operative complication or death occurred. Conversion to open surgery was required in two cases. Minor complications occurred in two patients (14.2%) due to pleural effusion. The mean hospitalization was 4.0 days. Five patients underwent adjuvant radiotherapy. All patients were alive with no disease recurrence, with a median follow-up of 14.5 months (range 1-98).
  
  
  CONCLUSIONS
  Robotic thymectomy is a safe and feasible technique, with a short operative time and low morbidity. Even on a small series with short follow-up, robotic extended thymectomy for thymoma appeared to be an effective treatment for early-stage thymomas.
authors.affiliation: Division of Thoracic Surgery, Department of Cardiac Thoracic and Vascular Surgery,  University of Pisa, Pisa,  Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mussi
authors.forename: Olivia
authors.initials: O
authors.lastname: Fanucchi
authors.forename: Federico
authors.initials: F
authors.lastname: Davini
authors.forename: Marco
authors.initials: M
authors.lastname: Lucchi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Picchi
authors.forename: Marcello Carlo
authors.initials: MC
authors.lastname: Ambrogi
authors.forename: Franca
authors.initials: F
authors.lastname: Melfi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D013934:Thymectomy / Q000009:adverse effects / Q000379:methods*; D013945:Thymoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013953:Thymus Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult