B. S. Hendriksen1, M. F. Reed1, C. S. Hollenbeak2, M. D. Taylor1 1Penn State Health Milton S Hershey Medical Center,Hershey, PA, USA 2Pennsylvania State University,University Park, PA, USA
Introduction:
Minimally invasive thymectomy operations are increasing and the impact on readmission and hospital length of stay merits contemporary evaluation. This study assessed surgical modality and other risk factors associated with 30-day unplanned readmission and hospital length of stay following thymectomy.
Methods:
The National Cancer Database was used to identify patients 18 years and older who underwent thymectomy between 2010 and 2015. Patient characteristics were compared using analysis of variance. Logistic regression and generalized linear modeling were used for multivariable analysis. Propensity score matching was used to control for covariate imbalance between modalities.
Results:
3,145 patients underwent thymectomy: 2,360 open, 379 VATS, and 406 robotic assisted. VATS and robotic approaches were less likely to have readmissions compared to open (OR=0.32, p=0.015, and OR=0.30, p = 0.0110, respectively). Length of stay for VATS was 1.2 days less than for open (p < 0.0001) and robotic had a length of stay 1.3 days less than open (p < 0.0001). Propensity score matching corroborated that unplanned readmission was increased in open vs VATS (p = 0.0100) and decreased in robotic vs open (p = 0.0180). Length of stay was significantly shorter for robotic compared to open (p = 0.0070).
Conclusion:
Minimally invasive surgery offers important benefits when compared to an open approach for thymectomy. VATS is associated with fewer readmissions and a robotic-assisted approach is associated with a shorter length of stay and fewer readmissions.