• Mediastinal surgery
• Myasthenia gravis
• Thymic neoplasm
• Thymectomy
• Robotic surgery
• Sternotomy

Extended thymectomy is considered the gold standard in the treatment of thymic neoplasm and it also plays a key role in the therapeutic path of Myasthenia gravis. Sternotomy has been for years the traditional approach for removing anterior mediastinal lesions, although the robotic thymectomy is now widely accepted and performed. Literature is still lacking in papers comparing the two approaches and evaluating oncological and neurological long-term outcomes. The aim of this study is to compare the surgical, neurological, and oncological outcomes of open and robotic thymectomy for thymic neoplasms in myasthenic patients. Data, from six Italian Thoracic Centers, of myasthenic patients affected by thymic neoplasm surgically treated with extended thymectomy, both with the open and the robotic approach, between 2011 and 2021, were evaluated. Surgical, oncological and neurological information were collected and analyzed. The robotic approach can be considered safe and feasible when comparable to the open technique in terms of surgical, oncological and neurological outcomes