Multifocal recurrence on the transaxillary robotic thyroidectomy incision

Chabrillac, Emilien; Zerdoud, Slimane; Fontaine, Sébastien; Sarini, J.

doi:10.1016/j.anorl.2019.05.007

Cited by 9 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…(II) In some patients, a small number of glands may be preserved at the suspensory ligament as appropriate to ensure postoperative voice function and quality of life. (III) Despite the large size of axillary cavity, direct removal of the specimens from the axillary cavity should be avoided, and transport by using a specimen bag can reduce the risk of thyroid or tumor implantation (13)(14)(15).…”

Section: Step 5: Exposure Dissection and Protection Of The Recurrent Laryngeal Nerve And The Inferior Parathyroid Gland And Central Neck mentioning

confidence: 99%

Gasless transaxillary endoscopic thyroidectomy for unilateral low- risk thyroid cancer: Li’s six-step method

Zhou¹,

Cai²,

Sun³

et al. 2021

Gland Surg

View full text Add to dashboard Cite

The past decade has witnessed rapid advances in gasless transaxillary endoscopic thyroidectomy (GTET) for thyroid cancer, which has become a reliable procedure with good therapeutic effectiveness, aesthetic benefits, and safety. This procedure has been widely promoted in some Asian countries; however, few studies have described the specific surgical steps for unilateral low-risk thyroid cancer. Based on a review of the literature and our own clinical experience, we introduce in detail the surgical procedure of GTET for the unilateral low-risk thyroid cancer, briefly summarized into Li's 6 steps: surgical position and incision design; creation of surgical cavities; dissection of the superior pole of the thyroid and its vessels, and identification and protection of superior laryngeal nerve; identification and protection of the superior parathyroid gland, and identification of the inferior parathyroid gland; identification and protection of the recurrent laryngeal nerve and the inferior parathyroid gland, and central neck dissection; and processing of the suspensory ligaments of thyroid gland and en bloc resection of the tumor. The six-step approach is simple to learn. The lymph nodes are dissected first, followed by resection of the primary lesion and protect important structures, which meets the principles of radical tumor treatment. It is hoped that the proposed Li's six-step method can promote the standardized, safe, and wide application in treating early thyroid cancer.

show abstract

Section: Step 5: Exposure Dissection and Protection Of The Recurrent Laryngeal Nerve And The Inferior Parathyroid Gland And Central Neck mentioning

confidence: 99%

Gasless transaxillary endoscopic thyroidectomy for unilateral low- risk thyroid cancer: Li’s six-step method

Zhou¹,

Cai²,

Sun³

et al. 2021

Gland Surg

View full text Add to dashboard Cite

show abstract

“…Iatrogenic implantation refers to the desquamation and dissemination of cells that develop into nodular recurrences. Some case reports have described this clinical condition for malignant and benign diseases [ 33 – 36 ]. In our case series, track seeding of a benign goiter occurred in 1 patient (0.2%), despite our routine use of an endobag to retrieve resected specimens.…”

Section: Discussionmentioning

confidence: 99%

Postsurgical complications after robot-assisted transaxillary thyroidectomy: critical analysis of a large cohort of European patients

et al. 2022

View full text Add to dashboard Cite

In the last decade, robot-assisted trans-axillary thyroidectomy has spread rapidly and has been proven to be a safe and effective procedure. However, several case series have reported new complications that have led to criticism regarding this approach. This study analyzed the incidence of complications in a large cohort of European patients. We enrolled all patients who underwent robot-assisted trans-axillary thyroidectomy from 2012 to 2020 at the University Hospital of Pisa Department of Endocrine Surgery. We analyzed complications and divided them into 2 groups. Group A included conventional complications, such as transient or permanent recurrent laryngeal nerve palsy, transient or permanent hypocalcemia, hemorrhage, and tracheal injury. Group B included unconventional complications, such as brachial plexus palsy, track seeding, seroma, great vessels injury, and skin flap perforation. There were 31 postsurgical complications (5.7%). Group A included 25 complications (4.6%): transient and permanent recurrent laryngeal nerve palsy occurred in 7 patients (1.3%) and in 1 (0.2%), respectively; transient and permanent hypocalcemia occurred in 9 patients (1.7%) and in 1 (0.2%), respectively. Postoperative bleeding occurred in 6 patients (1.1%) and tracheal injury in 1 (0.2%). Group B included 6 complications (1.1%): 1 patient with brachial plexus injury (0.2%), 1 with track seeding (0.2%), and 4 with seroma (0.7%). Robotic trans-axillary thyroidectomy is a safe approach with a risk of postoperative complications comparable to the conventional technique. Almost all complications after a novel introduction are anecdotal. With an accurate patient selection, high-volume institutions with experienced surgeons can perform this technique safely.

show abstract

“…A wet rolled gauze protects the recurrent laryngeal nerve (I), and the suspensory ligaments are progressively dissected. The thyroid gland, along with the central neck lymph nodes, is placed in a specimen bag and removed from the incision at the axilla to reduce the risk of thyroid and tumor implantation 24 . A closed negative pressure drain was placed on every patient.…”

Section: Surgical Techniquementioning

confidence: 99%

Comparison of health‐related quality of life and cosmetic outcome between traditional gasless trans‐axillary endoscopic thyroidectomy and modified gasless trans‐axillary endoscopic thyroidectomy for patients with papillary thyroid microcarcinoma

Dhoomun

Cai

et al. 2023

Cancer Medicine

View full text Add to dashboard Cite

BackgroundGasless trans‐axillary endoscopic thyroidectomy (GTET) has been proved to provide better cosmetic results; however, it has limitations as dissection of central neck lymph nodes is difficult. We developed a modified approach (MGTET‐modified GTET) and compared it with the traditional one in terms of patients' health‐related quality of life (HRQoL) and cosmetic results in order to provide more convincing therapeutic results.MethodsBetween January 2021 and June 2021, 100 cN0 patients who had a confirmed diagnosis of papillary thyroid microcarcinoma were randomized to undergo either MGTET (n = 50) or GTET (n = 50). These two groups' baseline characteristics, intraoperative and postoperative findings, were compared. The Patient and Observer Scar Assessment Scale (POSAS) was determined 6 months after surgery. Thyroid Cancer‐Specific Quality of Life Questionnaire was used to assess HRQoL at 1, 3, 6, and 12 months after surgery.ResultsM‐GTET was associated with a larger number of lymph nodes dissected (p < 0.001), lower drainage volume (p < 0.001), shorter hospital stay (p < 0.001), and shorter axillary incision (p < 0.001). POSAS was more favorable in M‐GTET. HRQoL was significantly better for MGTET in terms of less problems with scar (p < 0.001).ConclusionOur study suggests that MGTET provides better therapeutic, cosmetic, and HRQoL outcomes.

show abstract

Multifocal recurrence on the transaxillary robotic thyroidectomy incision

Cited by 9 publications

References 10 publications

Gasless transaxillary endoscopic thyroidectomy for unilateral low- risk thyroid cancer: Li’s six-step method

Gasless transaxillary endoscopic thyroidectomy for unilateral low- risk thyroid cancer: Li’s six-step method

Postsurgical complications after robot-assisted transaxillary thyroidectomy: critical analysis of a large cohort of European patients

Comparison of health‐related quality of life and cosmetic outcome between traditional gasless trans‐axillary endoscopic thyroidectomy and modified gasless trans‐axillary endoscopic thyroidectomy for patients with papillary thyroid microcarcinoma

Contact Info

Product

Resources

About