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Propensity score-matched analysis of robotic versus endoscopic bilateral axillo-breast approach (BABA) thyroidectomy in papillary thyroid carcinoma

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Abstract

Purpose

The da Vinci surgical robot system was developed to overcome the weaknesses of endoscopic surgery. However, whether robotic surgery is superior to endoscopic surgery remains uncertain. Therefore, the purpose of this study was to compare the surgical and oncologic outcomes between endoscopic and robotic thyroidectomy using bilateral axillo-breast approach (BABA).

Methods

Between January 2008 and June 2015, papillary thyroid carcinoma patients who underwent thyroidectomy with central neck dissection using endoscopic (n = 480) or robotic (n = 705) BABA were primarily reviewed. We performed 1:1 propensity score matching and 289 matched pairs were yielded.

Results

Operation time was significantly longer in the robotic thyroidectomy than in the endoscopic thyroidectomy (184.9 vs. 128.9 min, P < 0.001). A significantly higher number of central lymph nodes (CLNs) were resected in the robotic thyroidectomy than in the endoscopic thyroidectomy (5.3 vs. 4.4, P = 0.003). However, the incidence of other outcomes including hospital stay, postoperative duration, thyroglobulin level, radioactive iodine ablation, hemorrhage, chyle leakage, wound infection, recurrent laryngeal nerve injury, and loco-regional recurrence did not significantly differ between the endoscopic thyroidectomy and the robotic thyroidectomy.

Conclusions

Endoscopic thyroidectomy is comparable with robotic thyroidectomy in view of surgical complications and LRR. Because robotic thyroidectomy resected a larger number of CLNs than did endoscopic thyroidectomy, further long-term follow-up studies will be required to clarify the possible prognostic benefits of robotic thyroidectomy.

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Author’s contributions

Authorship K.S. K, J.S. K, and J.H. C participated in study conception and design, acquisition of the research data, analysis and interpretation of data, and writing of the manuscript; J.W. W, J.H. L, I. P, J.H. C, and J.H. K participated in study conception and design, analysis and interpretation of data, and critical revision of the manuscript.

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Authors and Affiliations

  1. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 135-710, South Korea

    Seo Ki Kim, Inhye Park, Jun-Ho Choe, Jung-Han Kim & Jee Soo Kim

  2. Department of Surgery, Changwon Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Changwon, South Korea

    Jung-Woo Woo

  3. Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea

    Jun Ho Lee

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  1. Seo Ki Kim
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Correspondence to Jun-Ho Choe or Jee Soo Kim.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

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There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs.

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Kim, S.K., Woo, JW., Park, I. et al. Propensity score-matched analysis of robotic versus endoscopic bilateral axillo-breast approach (BABA) thyroidectomy in papillary thyroid carcinoma. Langenbecks Arch Surg 402, 243–250 (2017). https://doi.org/10.1007/s00423-016-1528-7

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