Surgical Endoscopy

, Volume 27, Issue 8, pp 2955–2962

Robotic thyroidectomy by bilateral axillo-breast approach: review of 1026 cases and surgical completeness

Article

DOI: 10.1007/s00464-013-2863-1

Cite this article as:
Lee, K.E., Kim, E., Koo, D.H. et al. Surg Endosc (2013) 27: 2955. doi:10.1007/s00464-013-2863-1

Abstract

Background

Good postoperative and excellent cosmetic results have been achieved with bilateral axillo-breast approach (BABA) robotic thyroidectomy (RoT). This study was performed to analyze the surgical outcomes and evaluate the surgical completeness and safety of BABA RoT.

Methods

Between February 2008 and February 2012, a total of 1026 cases of BABA RoT were performed. The clinicopathologic characteristics, operation types, and postoperative outcomes of patients were analyzed.

Results

Of the 1026 cases analyzed, 968 cases were a malignant tumor and 58 cases were benign thyroid disease. Mean operating times for BABA total RoT with central lymph node dissection included 38 ± 13 min (range 20–90 min) of working space creation and 75 ± 26 min (range 25–175) of console time. Among the 872 patients who underwent total thyroidectomy with central lymph node dissection, transient hypoparathyroidism occurred in 39.1 %, transient vocal cord palsy occurred in 14.2 %, and permanent hypoparathyroidism and permanent vocal cord palsy occurred in 1.5 % and 0.2 % of patients, respectively. The median stimulated thyroglobulin (Tg) level of patients after their first radioactive iodine therapy was 0.4 ng/mL, with 65.1 % of patients having a stimulated Tg level of <1.0 ng/mL. The median suppressed Tg level at 3 postoperative months of patients without radioactive iodine therapy was <0.1 ng/mL, with 99.4 % of patients showing a suppressed Tg level of< 1.0 ng/mL. There was no recurrence or mortality after a median follow-up of 23 months.

Conclusions

BABA RoT is a safe and effective method that provides good surgical completeness and has low rates of postoperative complications and recurrence.

Keywords

Bilateral axillo-breast approach Robot Thyroid cancer Thyroidectomy 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Kyu Eun Lee
    • 1
    • 2
    • 3
  • Eunyoung Kim
    • 1
    • 2
    • 3
  • Do Hoon Koo
    • 2
    • 4
  • June Young Choi
    • 1
    • 2
    • 3
  • Kyu Hyung Kim
    • 5
  • Yeo-Kyu Youn
    • 1
    • 2
    • 3
  1. 1.Department of SurgerySeoul National University Hospital and College of MedicineSeoulSouth Korea
  2. 2.Cancer Research InstituteSeoul National University College of MedicineSeoulSouth Korea
  3. 3.Division of Surgery, Thyroid CenterSeoul National University Cancer HospitalSeoulSouth Korea
  4. 4.Department of SurgerySeoul National University Boramae Medical Center and College of MedicineSeoulSouth Korea
  5. 5.Department of SurgerySeoul National University Bundang HospitalSeoulSouth Korea

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