Unilateral axilla-bilateral areola approach for thyroidectomy by da Vinci robot vs. open surgery in thyroid cancer: a retrospective observational study

Zhang, Ye; Du, Junze; Ma, Jing; Liu, Jing; Cui, Xiang; Yuan, Jingkun; Zhang, Yi; Qi, Xiaowei; Fan, Liancheng

doi:10.21037/gs-20-831

Cited by 6 publications

(11 citation statements)

References 30 publications

(44 reference statements)

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“…Most common complications were transient RLN palsy (6.3%), transient hypoparathyroidism and hypocalcemia (20.5%), infection (0.5%), bleeding (0.4%), and seroma (0.3%) (Table 1). 2,5,9,14,17–19,59–69 In addition to the typical complications mentioned above, one approach‐specific complication was reported: pneumothorax (0.03%). The BABA procedure commonly caused sensory changes on the chestwall for several months after surgery; Kim et al.…”

Section: Resultsmentioning

confidence: 99%

“…Often mentioned advantages related to the use of robotic systems are the magnified 3D vision which prevents direct/indirect injuries to anatomical structures and permits precise manipulation due to the tremor filtration function. Allegedly, according to some authors, this could result in reduced complication rates and faster recovery times of the parathyroid and laryngeal function 59,65,69 . In terms of postoperative complications, however, the majority of the included comparative studies did not observe a statistical difference between robotic and open thyroidectomy approaches 5,9 .…”

Section: Discussionmentioning

confidence: 99%

“…5 Woo et al 66 reported a patient satisfaction of 6.9 on a scale of 1-10 (with increasing satisfaction). Finally, Zhang et al 69 reported a 91.2% satisfaction with the neck appearance in the BABA group, which was significantly higher than 21.6% in the open approach group.…”

Section: Cosmetic Satisfactionmentioning

confidence: 94%

“…Most common complications were transient RLN palsy (6.3%), transient hypoparathyroidism and hypocalcemia (20.5%), infection (0.5%), bleeding (0.4%), and seroma (0.3%) (Table 1). 2,5,9,14,[17][18][19][59][60][61][62][63][64][65][66][67][68][69] In addition to the typical complications F I G U R E 2 Overview of the division of included studies/ patients among different operative techniques.…”

Section: Complication Ratementioning

confidence: 99%

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Remote‐access robotic thyroidectomy: A systematic review

Vanermen

Poorten

Meulemans

2023

Robotics Computer Surgery

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Background Recently, robotic surgery has been introduced as a new surgical approach to the thyroid. Objectives The primary objective of this systematic review is to critically examine safety and feasibility of the different robotic approaches. Methods The literature on robotic thyroidectomy was systematically reviewed. Primary endpoints were surgery duration, length of hospital stay, complications, postoperative pain and cosmetic satisfaction. Results Sixty‐eight studies with a total of 14433 patients were included. Depending on the robotic approach used, operative duration ranged between 89 and 230 min and hospitalisation stay between 0.1 and 5.6 days. Complication rates varied between 7.3% and 29%. Postoperative pain visual analogue scores (VAS) ranged from 0.6 to 4.71. Conclusion Robotic thyroidectomy results in high cosmetic satisfaction and quality of life. No differences in complication rates between robotic and traditional approaches are observed, supporting safety and feasibility of these robotic techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Cosmetic Satisfactionmentioning

confidence: 94%

“…Most common complications were transient RLN palsy (6.3%), transient hypoparathyroidism and hypocalcemia (20.5%), infection (0.5%), bleeding (0.4%), and seroma (0.3%) (Table 1). 2,5,9,14,[17][18][19][59][60][61][62][63][64][65][66][67][68][69] In addition to the typical complications F I G U R E 2 Overview of the division of included studies/ patients among different operative techniques.…”

Section: Complication Ratementioning

confidence: 99%

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Remote‐access robotic thyroidectomy: A systematic review

Vanermen

Poorten

Meulemans

2023

Robotics Computer Surgery

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“…Zhang presenta una serie de 217 pacientes intervenidos (tiroidectomía total y disección central) con una variante técnica, robotizada pero con 3 puertos (dos pectorales pero solo uno axilar), con resultados comparables: 17,9% y 2% para el hipoparatiroidismo transitorio y permanente. Se refiere disfonía temporal en un caso (0,5%) aunque el protocolo de manejo no incluye la evaluación directa de la movilidad de las cuerdas vocales [24].…”

Section: Actualización En Cirugía Tiroidea De Acceso Remotounclassified

Actualización en cirugía tiroidea y paratiroidea de acceso remoto

Granell

2021

ORL

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Introducción y objetivo: El desarrollo de las técnicas de acceso remoto para cirugía de tiroides y paratiroides en los últimos años ha llevado a la consolidación de las cuatro configuraciones que actualmente se utilizan de manera estándar. El objetivo de esta revisión es describir la experiencia acumulada en tiroidectomía y paratiroidectomía por abordaje axilar, axilo-pectoral bilateral, retroauricular y transoral, así como exponer los resultados publicados por los diferentes grupos. Síntesis: El abordaje transaxilar fue el primero que se describió y tiene las series más antiguas y algunas de las más numerosas, cuyos resultados reproducen los estándares de la cirugía abierta para las mismas indicaciones. Sin embargo en los últimos años se ha ido abandonando a favor de abordajes alternativos. El abordaje retroauricular se describió inicialmente para la cirugía de tiroides, pero sus indicaciones han migrado hacia otra patología cervical. El abordaje axilopectoral bilateral ha sido extensamente utilizado en cirugía de tiroides y reproduce no solo los exigentes estándares respecto a las lesiones recurrenciales y el hipopartiroidismo postoperatorio, sino también los estándares oncológicos en el manejo quirúrgico del carcinoma diferenciado de tiroides. El abordaje transoral / transvestibular, el último en llegar, se encuentra en franca expansión y es potencialmente aplicable a la mayoría de los casos quirúrgicos de tiroides y paratiroides. Conclusiones: Las técnicas de acceso remoto han demostrado ser seguras y eficaces. El volumen de actividad publicado y los resultados las convertirían ya en procedimientos estándar, aunque sigue siendo necesario comprobar en series multicéntricas prospectivas la reproductibilidad de los resultados.

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Prospective cohort study of parathyroid function and quality of life after total thyroidectomy for thyroid cancer: robotic surgery vs. open surgery

Qin,

Luo,

et al. 2023

International Journal of Surgery

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Objective: To compare robot-assisted thyroidectomy (RT) and open thyroidectomy (OT) through a prospective cohort study focusing on the rate of postoperative hypoparathyroidism, efficacy, and quality of life (QoL). Summary Background Data: Hypoparathyroidism is a frequent complication after thyroidectomy. Reducing the risk of hypoparathyroidism after total thyroidectomy is a crucial and difficult task for thyroid surgeons. Methods: We prospectively enrolled 306 patients with papillary thyroid carcinoma(PTC) into an RT group and OT group. The former used “super-meticulous” capsular dissection (SMCD) and the latter used traditional meticulous capsular dissection. Patients were evaluated by scales [Short Form (SF)-36, Visual Impairment Scale (VIS), Swallowing Impairment Scale (SIS), Neck Impairment Scale (NIS), Scar questionnaire (SCAR-Q)]. Results: The rates of transient hypoparathyroidism, permanent hypoparathyroidism, and transient hypocalcemia after surgery in the OT group and RT group were significantly different (P<0.001). SIS and VIS scores in the two groups were significantly different (P<0.001). SF-36 showed significant differences (P<0.001) in the subsections of “physiological function”, “body pain”, “general health”, “vitality”, “social function”, “role emotional”, and “mental health” between the two groups. SCAR-Q showed that the length and appearance of scars showed significant differences between the two groups. Conclusions: Robot-assisted thyroidectomy with Super-meticulous capsular dissection can protect parathyroid function and improve postoperative QoL, and could be a new option for robot-assisted surgery against thyroid cancer.

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Unilateral axilla-bilateral areola approach for thyroidectomy by da Vinci robot vs. open surgery in thyroid cancer: a retrospective observational study

Cited by 6 publications

References 30 publications

Remote‐access robotic thyroidectomy: A systematic review

Remote‐access robotic thyroidectomy: A systematic review

Actualización en cirugía tiroidea y paratiroidea de acceso remoto

Prospective cohort study of parathyroid function and quality of life after total thyroidectomy for thyroid cancer: robotic surgery vs. open surgery

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