Transaxillary robotic modified radical neck dissection: a 5-year assessment of operative and oncologic outcomes

Kim, Min Jhi; Lee, Jandee; Lee, Seul Gi; Choi, Jun Shik; Kim, Tae Hyung; Ban, Eun Jeong; Lee, Cho Rok; Kang, Sang‐Wook; Jeong, Jong Ju; Nam, Kee Hyun; Jo, Young Suk; Chung, Woong Youn

doi:10.1007/s00464-016-5146-9

Cited by 38 publications

(32 citation statements)

References 25 publications

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“…None of the studies had randomization performed between the two groups. Six of the studies involved patients with head and neck malignancy who underwent a retroauricular approach to the neck, whereas five of the studies consisted of patients with PTC who underwent a transaxillary approach. The total sample sizes ranged from nine to 143, whereas the robotic and conventional group sample sizes spanned from three to 62 and six to 102, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…In seven studies, patients underwent selective neck dissection (SND). In four studies, patients were subjected to modified radical neck dissection . Three studies performed neck dissection electively on the N0 neck, whereas eight studies included only therapeutic neck dissections in their patient cohorts.…”

Section: Resultsmentioning

confidence: 99%

“…In four studies, patients were subjected to modified radical neck dissection . Three studies performed neck dissection electively on the N0 neck, whereas eight studies included only therapeutic neck dissections in their patient cohorts. All studies utilized the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA) in their robotic‐assisted interventions.…”

Section: Resultsmentioning

confidence: 99%

“…Following this, Kim et al combined the facelift and transaxillary approach to perform neck dissections in head and neck squamous cell carcinoma. Multiple case series and comparative studies, primarily out of South Korea, subsequently highlighted the feasibility of nodal dissection through robotic transaxillary, retroauricular, and modified facelift approaches . Despite the embrace of this technology in East Asia, studies remain limited in the head and neck surgical literature.…”

Section: Introductionmentioning

confidence: 99%

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Robotic versus conventional neck dissection: A systematic review and meta‐analysis

et al. 2018

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Objective: The aim of this systematic review is to compare the perioperative outcomes of robotic versus conventional neck dissection in patients with head and neck malignancy.Methods: An electronic search of PubMed, Web of Science, and EMBASE databases was conducted. We included studies with direct comparisons of robotic and open neck dissections and performed dual, independent data extraction for primary outcomes of nodal yield, recurrence rate, subjective cosmetic assessment, operative time, length of stay, and rates of perioperative complications. Data were pooled using random effects meta-analysis to determine the standardized mean difference (SMD), absolute risk difference (RD), and 95% confidence intervals (CI).Results: Eleven comparative studies comprising 225 robotic and 430 open neck dissections met the final selection criteria. All studies had low to moderate risk of bias. Robotic surgery improved cosmesis (SMD 1.15, 95% CI 0.73 to 1.56) but also increased operative time (SMD 1.94, 95% CI 1.25 to 2.63). Total nodal yield, pathological nodal yield, recurrence rate, rates of perioperative complications, and length of stay were not significantly different between the two groups, and the 95% CIs suggested that false negative results were unlikely. The results remained consistent after stratification by pathology and robotic technique.Conclusion: Although robotic neck dissection may offer similar perioperative outcomes compared to conventional neck dissection, it requires significantly more operative time. Whereas cosmesis was found to be superior among the robotic cohort, this must be viewed cautiously given the nonvalidated measurement tool that was used and the inherent reporting bias associated with it.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robotic versus conventional neck dissection: A systematic review and meta‐analysis

et al. 2018

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“…Moreover, very few patients in our study needed to be operated on again (3/42), and all these patients already had metastatic lymph node at initial diagnosis. Robotic neck dissection via the transaxillary approach was also reported to be safe in patients with papillary thyroid carcinoma and lateral neck node metastasis (N1b) at 5 years postoperatively [17]. It is noteworthy that even aggressive histology has been treated by robotic surgery.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Differentiated Thyroid Carcinoma with Transaxillary Robotic Surgery and Radioiodine: The First European Experience

et al. 2018

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Objectives: Transaxillary robotic thyroidectomy surgery (TARS) has been reported to be a safe approach in patients with differentiated thyroid carcinoma, and oncological responses are promising. Study Design: This study aimed to evaluate the oncological outcomes of TARS followed by radioiodine (RAI) therapy in patients with differentiated thyroid carcinoma. Between 2011 and 2016, patients treated for differentiated thyroid carcinoma by TARS in a single institution, followed by RAI, were retrospectively included. The oncological response was performed according to the 2015 American Thyroid Association (ATA) guidelines 6–12 months later and at the last available visit. Results: A total of 42 patients (30 females) were included, with a median tumor size of 20 mm (12 cases of N1a and 5 cases of N1b on initial pathology report). According to ATA classification of recurrence risk after surgery, 17 and 25 patients were classified as low and intermediate risk, respectively. After RAI, all patients had a normal posttherapeutic whole body scan (except 1 patient, who had pathological lymph node uptake), but no unusual uptake was seen. At the 6- to 12-month evaluation (n = 37), 24 patients had excellent response, 8 had indeterminate response, and 5 had incomplete response (2 biological and 3 structural); no distant metastasis was found. At the last evaluation (median follow-up 15.9 months), 35 patients had no evidence of disease and 1 patient had a structural incomplete response. In total, a second open surgery was necessary for 3 patients to treat persistent lymph nodes (all intermediate risk). Conclusion: In this study, TARS followed by RAI therapy seems to be curative, even for patients with lymph node metastases, after good preoperative staging. More studies are required to confirm the findings.

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Single‐Port Transaxillary Robotic Modified Radical Neck Dissection (STAR‐RND): Initial Experiences

Kim

Lee

et al. 2022

The Laryngoscope

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Objectives This study aimed to demonstrate the usefulness of single‐port transaxillary robotic modified radical neck dissection (STAR‐RND) for metastatic thyroid cancer, and its potential to make small and invisible surgical wounds possible compared to open modified radical neck dissection. Methods Between January 2020 and July 2021, 30 thyroid cancer patients who underwent lateral neck dissection surgery with the da Vinci SP at Yonsei University Health System (Seoul, Korea) were studied. Results All 30 patients, diagnosed with papillary thyroid cancer were women. The average operating time was 293.80 ± 36.58 (min), and the average postoperative hospital stay was 4.77 ± 0.57 (days). All patients were discharged after the expected number of hospitalization days without major complications. Conclusion STAR‐RND is technically feasible and safe with a short length of the incision. To our knowledge, this is the first report on the use of a single‐port robotic system for modified radical neck dissection. Level of Evidence by Using 2011 OCEBM 4 Laryngoscope, 133:709–714, 2023

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Transaxillary robotic modified radical neck dissection: a 5-year assessment of operative and oncologic outcomes

Abstract: The perioperative and 5-year oncologic outcomes were similar after robotic and conventional open MRND. Large, prospective randomized controlled trials with long-term follow-up data are needed to validate these results.

Cited by 38 publications

References 25 publications

Robotic versus conventional neck dissection: A systematic review and meta‐analysis

Robotic versus conventional neck dissection: A systematic review and meta‐analysis

Successful Treatment of Differentiated Thyroid Carcinoma with Transaxillary Robotic Surgery and Radioiodine: The First European Experience

Single‐Port Transaxillary Robotic Modified Radical Neck Dissection (STAR‐RND): Initial Experiences

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