Comparison of Robotic versus Conventional Selective Neck Dissection and Total Thyroidectomy for Papillary Thyroid Carcinoma

Song, Chang Myeon; Ji, Yong Bae; Sung, Eui Suk; Kim, Dong Sun; Koo, Hye Ryoung; Tae, Kyung

doi:10.1177/0194599816638084

Cited by 29 publications

(49 citation statements)

References 31 publications

(138 reference statements)

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“…In our literature review, we found that our experience of needle‐assisted endoscopic LND technique was associated with higher lymph node yield compared with any other studies listed in Table . As seen in Figure , we completely removed the lymph nodes and relative soft tissues at level II and around the venous angle without remaining visible structural disease, intraoperatively.…”

Section: Discussionmentioning

confidence: 79%

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

et al. 2019

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Background: Endoscopic thyroidectomy is popular among patients with cosmetic requirements. However, when lateral neck dissection (LND) is required, endoscopic surgery may be challenging. Therefore, we introduced needle-assisted endoscopic technique to achieve endoscopic LND procedure and evaluated its safety and feasibility in the present study. Methods: Medical records of 37 patients who underwent needle-assisted endoscopic thyroidectomy with LND were retrospectively reviewed. Results: All of 37 patients had excellent cosmetic outcomes. The mean operative time was 338.2 ± 58.74 minutes. Mean number of lymph nodes retrieved in the lateral was 33.5 ± 11.69 and 15.9 ± 7.51 in the central neck. The rates of transient and permanent hypocalcemia were 32.4% and 2.7% and the rates of transient and permanent recurrent laryngeal nerve palsy were 8.1% and 0%, respectively. Conclusions: Needle-assisted endoscopic thyroidectomy with lateral neck dissection shows potential feasibility but further study is needed to better characterize its safety and applicability. K E Y W O R D Spapillary thyroid carcinoma, endoscopic thyroidectomy, lateral neck dissection, needle assisted, anterior chest approach

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Section: Discussionmentioning

confidence: 79%

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

et al. 2019

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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%

“…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%

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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“…It has been reported that patients who undergo endoscopic or robotic surgery on the neck or thyroid suffer from moderate to severe neck, anterior chest, and axillary pain following surgery. [1,3] In addition, about 70% of patients complain of anterior chest discomfort within 4 days after endoscopic thyroidectomy, [4] and hypoesthesia with discomfort to the anterior chest area may persist for 3 months following surgery. [5] Postoperative pain is associated with reduced quality of recovery, delayed mobilization, prolonged hospitalization, and the development of chronic pain syndrome.…”

Section: Introductionmentioning

confidence: 99%

Prospective, randomized, and controlled trial on ketamine infusion during bilateral axillo-breast approach (BABA) robotic or endoscopic thyroidectomy

Kim

Choi²,

Kim

et al. 2016

Medicine

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Background:Robotic or endoscopic thyroidectomy using bilateral axillo-breast approach (BABA) is frequently performed for excellent cosmesis. However, postoperative pain is remained as concerns due to the extent tissue dissection and tension during the operation. Ketamine is a noncompetitive N-methyl-d-aspartate (NMDA) receptor antagonist that reduces acute postoperative pain. We evaluated the effects of intraoperative ketamine infusion on postoperative pain control and recovery profiles following BABA robotic or endoscopic thyroidectomy.Methods:Fifty-eight adult patients scheduled for BABA robotic or endoscopic thyroidectomy were randomized into a control group (n = 29) and ketamine group (n = 29). Following induction of anesthesia, patients in each group were infused with the same volume of saline or ketamine solution (1 mg/kg bolus, 60 μg/kg/h continuous infusion). Total intravenous anesthesia with propofol and remifentanil was used to induce and maintain anesthesia. Pain scores (101-point numerical rating scale, 0 = no pain, 100 = the worst imaginable pain), the consumption of rescue analgesics, and other postoperative adverse effects were assessed at 1, 6, 24, and 48 hours postoperatively.Results:Patients in the ketamine group reported lower pain scores than those in the control group at 6 hours (30 [30] vs 50 [30]; P = 0.017), 24 hours (20 [10] vs 30 [20]; P < 0.001), and 48 hours (10 [10] vs 20 [15]; P < 0.001) in neck area. No statistically significant differences were found between the 2 groups in terms of the requirements for rescue analgesics or the occurrence of adverse events.Conclusion:Intravenous ketamine infusion during anesthesia resulted in lower postoperative pain scores following BABA robotic or endoscopic thyroidectomy, with no increase in adverse events.

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Comparison of Robotic versus Conventional Selective Neck Dissection and Total Thyroidectomy for Papillary Thyroid Carcinoma

Abstract: Compared with conventional transcervical SND with total thyroidectomy, robotic SND with total thyroidectomy yields superior outcomes for cosmetic satisfaction, longer operative time, and higher chest pain in the short term. Further study with a larger number of patients is mandatory.

Cited by 29 publications

References 31 publications

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

Feasibility and safety of needle‐assisted endoscopic thyroidectomy with lateral neck dissection for papillary thyroid carcinoma: a preliminary experience

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

Prospective, randomized, and controlled trial on ketamine infusion during bilateral axillo-breast approach (BABA) robotic or endoscopic thyroidectomy

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