Variations and results of retroauricular robotic thyroid surgery associated or not with neck dissection

Lira, Renan Bezerra; Chulam, Thiago Celestino; Kowalski, Luiz Paulo

doi:10.21037/gs.2018.03.04

Cited by 20 publications

(14 citation statements)

References 56 publications

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“…Numerous publications have shown the safety and favorable outcomes of retroauricular robotic neck dissections, without any major complications or surgery related deaths (Albergotti et al, 2016; Albergotti, Kenneth Byrd, De Almeida, Kim, & Duvvuri, 2014; Byeon et al, 2014; Byeon et al, 2015; Kim et al, 2014; Kim et al, 2015; Kim, Chang, et al, 2013; Kim, Koh, et al, 2013; Lee et al, 2012; Lira, Chulam, de Carvalho, et al, 2018; Lira, Chulam, & Kowalski, 2018; Morton, Gray, Tandon, Izzard, & McIvor, 2009; Park et al, 2013; Shin, Choi, Kim, & Koh, 2014; Tae et al, 2013; Tae et al, 2014). A systematic review and meta‐analysis including 11 studies and more than 200 patients confirmed the significantly longer operative time in the group of patients who underwent robotic neck dissection.…”

Section: Reported Resultsmentioning

confidence: 99%

“…The postoperative recovery, including hospital stay, is comparable to conventional neck dissection. Of our six publications focused on retroauricular access techniques (Chulam et al, 2016; de Brito Neves, Lira, Chulam, & Kowalski, 2020; Lira et al, 2016; Lira et al, 2017; Lira, Chulam, de Carvalho, et al, 2018; Lira, Chulam, & Kowalski, 2018), in one we performed a comparison of conventional neck dissection versus endoscopic or robotic retroauricular for oral cancer, with 60 patients included, showing similar survival results and complication rates (Lira, Chulam, de Carvalho, et al, 2018), and satisfactory cosmetic results (Figure 2). The additional cost related to robotic neck dissection in our institution is ~1,000 USD (paid by the patients), which compose, together with the longer operative time, the only disadvantages of this technique for the patients and their surgeons.…”

Section: The a C Camargo Cancer Center Experiencementioning

confidence: 99%

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Anatomy, technique, and results of robotic retroauricular approach to neck dissection

Kowalski

Lira

2021

The Anatomical Record

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In the attempt to improve the cosmetic and functional outcomes in head and neck surgeries, robotic or video-assisted neck dissection using remote access has gained ground in recent years. Retroauricular approach emerged as the most versatile option, allowing proper dissection at all neck levels. In this technique, after retroauricular incision, a skin flap is elevated and a self-retaining retractor is placed, creating working space for the robotic, or endoscopic neck dissection. Numerous published series have shown the safety and favorable outcomes of retroauricular robotic neck dissections, without any major complications or surgery-related deaths. The only consistently reported disadvantage is a longer operative time. Our group has an experience of 190 retroauricular neck dissections performed over the last 5 years, without any major setbacks. The oncologic and safety outcomes have been comparable to the conventional technique, with clearly superior aesthetic results. In the process of expansion of Robotic Surgery in Brazil, our center is currently providing training and proctoring to capacitate other head and neck surgeons, and enable other centers to offer this surgical modality.

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Section: Reported Resultsmentioning

confidence: 99%

Section: The a C Camargo Cancer Center Experiencementioning

confidence: 99%

Anatomy, technique, and results of robotic retroauricular approach to neck dissection

Kowalski

Lira

2021

The Anatomical Record

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“…Here, we present for the first-time clinical results directly comparing two remote approaches in thyroid surgery regarding perioperative outcome and quality of life. Remote access endoscopic thyroid surgery has recently been shown to be safe and efficient not only in treatment of benign disease, but also for differentiated thyroid cancer [3,7,9,20,38].…”

Section: Discussionmentioning

confidence: 99%

“…One is that we reported the outcome of only a small number of patients in a highly selected collective from a single center. However, other groups also report only a small number of cases with a low degree of evidence [8,10,12,18,20,21,25,[39][40][41][42]. Furthermore, there is a bias due to patient selection for either one of the endoscopic or open procedures, as the EndoCATS approach can only be used for unilateral resections, whereas the ABBA technique is suitable for uni-and bilateral resections but only in female patients.…”

Section: Discussionmentioning

confidence: 99%

Quality of life and surgical outcome of ABBA versus EndoCATS endoscopic thyroid surgery: a single center experience

et al. 2021

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Background Thyroid surgery is often performed, especially in young female patients. As patient satisfaction become more and more important, different extra-cervical “remote” approaches have evolved to avoid visible scars in the neck for better cosmetic outcome. The most common remote approaches are the transaxillary and retroauricular. Aim of this work is to compare Endoscopic Cephalic Access Thyroid Surgery (EndoCATS) and axillo-bilateral-breast approach (ABBA) to standard open procedures regarding perioperative outcome and in addition to control cohorts regarding quality of life (QoL) and patient satisfaction. Methods In a single center, 59 EndoCATS und 52 ABBA procedures were included out of a 2 years period and compared to 225 open procedures using propensity-score matching. For the endoscopic procedures, cosmetic outcome, patient satisfaction and QoL (SF-12 questionnaire) were examined in prospective follow-up. For QoL a German standard cohort and non-surgically patients with thyroid disease were used as controls. Result The overall perioperative outcome was similar for all endoscopic compared to open thyroid surgeries. Surgical time was longer for endoscopic procedures. There were no cases of permanent hypoparathyroidism and no significant differences regarding temporary or permanent recurrent laryngeal nerve (RLN) palsies between open and ABBA or EndoCATS procedures (χ2; p = 0.893 and 0.840). For ABBA and EndoCATS, 89.6% and 94.2% of patients were satisfied with the surgical procedure. Regarding QoL, there was an overall significant difference in distribution for physical, but not for mental health between groups (p < 0.001 and 0.658). Both endoscopic groups performed slightly worse regarding physical health, but without significant difference between the individual groups in post hoc multiple comparison. Conclusion Endoscopic thyroid surgery is safe with comparable perioperative outcome in experienced high-volume centers. Patient satisfaction and cosmetic results are excellent; QoL is impaired in surgical patients, as they perform slightly worse compared to German standard cohort and non-surgical patients.

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“…A local study involving 48 patients reports that three of them evolved with the referred condition (6.2%). 5 advanced thyroid cancer, hyperthyroidism, total thyroidectomy. 2,3,[6][7][8][9][10] Calcium supplementation in the TT postoperative period is common practice and studies show that there is no consensus on the time and amount to be used.…”

Section: Introductionmentioning

confidence: 99%

Prevention of hypoparathyroidism with the use of calcium-rich foods in the total thyroidectomy pre-operative period

Segal

Aquino

Leandro-Merhi

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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Background: Transient hypocalcemia after total thyroidectomy (TT) is a common surgical complication. Authors used calcium supplements in different doses and periods, mainly after TT to try to avoid hypocalcemia. Indistinct use has been challenged due to complications. Currently, the risk of hypocalcemia was assessed by measuring parathormone (PTH) after TT; however, without a consensus on the best time and amount to consider. The objectives of this study were to evaluate the incidence of hypoparathyroidism with the use of calcium-rich foods in the pre-operative period of TT, followed by a measurement of PTH performed 12 hours after such procedureMethods: A preliminary study with 31 patients earmarked for TT. Patients were divided into two groups: (A) without calcium-rich foods intake in the TT pre-operative period; and (B) with the intake of calcium-rich foods, in the TT pre-operative period. These foods composing different menus have been suggested, based on the need for daily calcium intake, according to the age group and nutritional data of the Dietary reference intake (DRI). Beginning of the use of these foods has been standardized as being seven days before surgery, due to the slower calcium intestinal absorption process. Results: Group B, when compared to A, showed a significant difference between PTH values, before and after surgery (p value <0.001).Conclusions: Calcium-rich foods intake in the conditions reported may be associated with lower rates of hypoparathyroidism.

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Variations and results of retroauricular robotic thyroid surgery associated or not with neck dissection

Cited by 20 publications

References 56 publications

Anatomy, technique, and results of robotic retroauricular approach to neck dissection

Anatomy, technique, and results of robotic retroauricular approach to neck dissection

Quality of life and surgical outcome of ABBA versus EndoCATS endoscopic thyroid surgery: a single center experience

Prevention of hypoparathyroidism with the use of calcium-rich foods in the total thyroidectomy pre-operative period

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