A Systematic Review and Meta-analysis Comparing Surgically-Related Complications between Robotic-Assisted Thyroidectomy and Conventional Open Thyroidectomy

Lang, Brian Hung‐Hin; Wong, Carlos K. H.; Tsang, Julia Y. S.; Wong, Kai Pun; Wan, Koon Yat

doi:10.1245/s10434-013-3406-7

Cited by 97 publications

(81 citation statements)

References 39 publications

(112 reference statements)

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“…In their recent meta-analysis of 2375 patients from 11 studies, Lang et al reported longer operative times (mean difference = 56 minutes), hospital stay, and increased transient RLN injury rates in patients undergoing robotic thyroidectomy compared with those who underwent conventional transcervical thyroidectomy (21). There was no difference between the two procedures regarding blood loss, hypocalcemia, and overall morbidity.…”

Section: Comparison With Conventional Thyroidectomymentioning

confidence: 99%

American Thyroid Association Statement on Remote-Access Thyroid Surgery

Berber

Bernet

Fahey

et al. 2016

Thyroid

202

179

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Background: Remote-access techniques have been described over the recent years as a method of removing the thyroid gland without an incision in the neck. However, there is confusion related to the number of techniques available and the ideal patient selection criteria for a given technique. The aims of this review were to develop a simple classification of these approaches, describe the optimal patient selection criteria, evaluate the outcomes objectively, and define the barriers to adoption. Methods: A review of the literature was performed to identify the described techniques. A simple classification was developed. Technical details, outcomes, and the learning curve were described. Expert opinion consensus was formulated regarding recommendations for patient selection and performance of remote-access thyroid surgery. Results: Remote-access thyroid procedures can be categorized into endoscopic or robotic breast, bilateral axillobreast, axillary, and facelift approaches. The experience in the United States involves the latter two techniques. The limited data in the literature suggest long operative times, a steep learning curve, and higher costs with remote-access thyroid surgery compared with conventional thyroidectomy. Nevertheless, a consensus was reached that, in appropriate hands, it can be a viable option for patients with unilateral small nodules who wish to avoid a neck incision. Conclusions: Remote-access thyroidectomy has a role in a small group of patients who fit strict selection criteria. These approaches require an additional level of expertise, and therefore should be done by surgeons performing a high volume of thyroid and robotic surgery.

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Section: Comparison With Conventional Thyroidectomymentioning

confidence: 99%

American Thyroid Association Statement on Remote-Access Thyroid Surgery

Berber

Bernet

Fahey

et al. 2016

Thyroid

202

179

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“…The blood loss is also similar. Only one meta-analysis reported a significantly higher rate of transient recurrent laryngeal nerve palsy after RT [7]. There is no significant difference in the long-term voice outcomes, assessed by VHI and GRBAS scale [11,12].…”

Section: Discussionmentioning

confidence: 95%

“…Multiple meta-analysis with large series compared RT to OT [3][4][5][6][7][8][9][10], without noticing any significant difference in most of the surgical complications: transient or permanent hypoparathyroidism, permanent recurrent laryngeal nerve palsy, hematoma, seroma... The blood loss is also similar.…”

Section: Discussionmentioning

confidence: 99%

“…However, the RT implies: -a significantly increased operative time (mean difference=56 minutes), which is known to be a risk factor of surgical-site infections in the thyroid surgery [14], -a significantly longer mean hospital stay, according to a metaanalysis by Lang et al [7], -an increased global cost ($13,087 vs. $9,028) related to the consumables, the maintenance, the duration of the hospital stay and of the operating room occupation [2,15]. Some unusual risks of the RT must be quoted [16]: flap perforation (0.1%), paresthesia and fibrosis along the flap, brachial plexus traction injury (0.1%), great vessels injury at the thoracic outlet (0.03%), tracheal (0.2%) or carotid injury (0.03%), more frequent due to the absence of force feedback, or even disturbance of the interpretation of future mammograms [17].…”

Section: Discussionmentioning

confidence: 99%

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Report of a Track Seeding of Thyroid Papillary Carcinoma During Robot- Assisted Transaxillary Thyroidectomy

Chabrillac¹,

Zerdoud²,

Graff-Cailleaud³

et al. 2017

Thyroid Disorders Ther

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Background: The Robotic Thyroidectomy (RT) is a minimally invasive surgical technique initially developed in Asia, for cultural reasons. The principles of its use are still undergoing development. Showing to all appearances satisfying outcomes, the long-time safety and medico-economic benefit of the procedure have not been established yet. The use of this technique in thyroid carcinology remains rare, and provides specific risks, not encountered with the Open Thyroidectomy (OT).

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“…에서 동일하며, (183)(184)(185)189,191,(193)(194)(195)197) 수술의 합병증은 일시적 부갑상선 기능저하, (183)(184)(185)(186)(188)(189)(190)192,193,195,199) 영구적 부갑상선 지능저하, (183)(184)(185)(186)(187)(188)(189)(190)(191)(192)(193)(194)(195)199) 되돌이 후두 신경 손 상, (183)(184)(185)(186)(187)(189)(190)(191)(192)(193)(194)(195)199) 장액종, (183)(184)(185)…”

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