Surgical outcomes of robotic thyroidectomy vs. conventional open thyroidectomy for papillary thyroid carcinoma

Abstract

BackgroundThe purpose of this study was to compare the surgical outcomes of robotic thyroidectomy (RT) using bilateral axillo-breast approach (BABA) with conventional open thyroidectomy (OT) in papillary thyroid carcinoma patients.MethodsBetween January 2009 and December 2013, 815 patients who had received thyroidectomy for papillary thyroid carcinoma were enrolled. Of these, 126 patients received RT and 689 patients underwent OT. Age, gender, body mass index, extent of surgery, tumor size, multiplicity, bilaterality, extrathyroidal extension, and tumor stage were used for the propensity score matching analysis. One hundred and nine patients were selected in each group, and surgical outcomes were compared between the two groups.ResultsThe RT group showed a significantly longer operating time (290.6 ± 74.4 vs. 107.9 ± 30.8 min, P < 0.001). However, the mean hospital stay after surgery (3.6 ± 0.8 vs. 3.4 ± 1.2 days, P = 0.293), postoperative complication rates (major and minor, P = 0.754 and P = 0.852), and pain score (postoperative day, P = 0.669; postoperative day 1, P = 0.952) were comparable between the two groups. There was no difference in the number of metastatic lymph nodes, but the mean number of retrieved lymph nodes in the RT group was lesser than that in the OT group (3.5 ± 3.5 vs. 5.3 ± 5.2, P = 0.002).ConclusionsRobotic thyroidectomy via the BABA may be a safe and acceptable surgical technique. But, further development that resolves the limitation of central node dissection is needed.

Bilateral axillo-breast approach robotic thyroidectomy: review of evidences

“…In the literature, there are 11 studies comparing the outcomes between BABA RT and OT ( Table 1) (27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). All except one study are originated from South Korea which represents the major and leading body of worldwide experiences and evidences (27)(28)(29)(30)(31)(32)(33)(34)(35)(36).…”

Oncoplastic Thyroid Surgery Using A Bilateral Axillo-Breast Approach

“…[5][6][7][8][9][10] In addition, rates of transient and permanent RLN injury did not differ significantly in patients undergoing BABA RT and OT. [6][7][8][9]11 In BABA RT, intraoperative neuromonitoring (IONM) has been used to identify the RLN and to assess vocal cord function. Postoperative transient and permanent vocal cord palsy were not observed by indirect laryngoscopy, with rates of transient RLN palsy being less than 2%.…”

“…In some studies, transient and permanent hypoparathyroidism were classified as abnormalities lasting less than and more than 6 months, respectively. [5][6][7]11 In other institution, transient and permanent hypoparathyroidism were based on low serum Ca and PTH levels and the need for Ca supplementation 1 year after BABA RT. 8 The rate of permanent hypoparathyroidism in patients who underwent BABA RT was less than 2%.…”

“…8 The rate of permanent hypoparathyroidism in patients who underwent BABA RT was less than 2%. [5][6][7][8][9][10][11] Moreover, in five studies that compared BABA RT and OT, the incidence of permanent hypoparathyroidism was comparable in the two groups. [6][7][8][9]11 Other complications…”

“…Another study reported that postoperative pain score at operation day and postoperative 1day was no significant differences between patients who underwent BABA RT or OT (3.84±1.11 vs. 3.76± 1.22, p=0.069). 11 …”