Comparison of postoperative surgical stress following robotic thyroidectomy and open thyroidectomy: a prospective pilot study
Robotic thyroid surgery using the da Vinci surgical system has certain cosmetic advantages; however, the invasiveness of robotic thyroid surgery is still a concern to many surgeons. Previous research has not directly compared the surgical stress of robotic thyroidectomy with that of conventional open surgery. The aim of the present study was to evaluate surgical stress using postsurgical measurements of several clinical markers.
A pilot study was performed to evaluate surgical stress following robotic and open thyroid surgery. A total of 29 papillary thyroid cancer patients from July to November 2014 were enrolled. Fourteen patients underwent conventional open surgery, and fifteen underwent robotic thyroidectomy. IL-6 levels, serum WBC counts, CRP levels, surgical plethysmographic index (SPI), and visual analogue scale (VAS) score were measured to compare surgical stress between the robotic and the open surgery groups.
No significant differences were seen between the two groups in IL-6 level, WBC count or CRP level (p = 0.380, 0.374, 0.360, respectively). Mean SPI level during the surgery was 41.9 ± 4.7 in open group compared to 39.5 ± 2.2 in robotic group, though this finding showed borderline significance (p = 0.095). VAS score after open surgery was significantly higher than after robotic operation (p = 0.048).
The results of this study suggest that robotic thyroidectomy can result in a less than equivocal systemic stress response than is seen in open thyroidectomy. However, further investigation including large-scale, prospective, multicenter studies is warranted for non-inferiority trials.
KeywordsSurgical stress Robotic thyroidectomy IL-6 SPI VAS
Compliance with ethical standards
Se Hyun Paek, Kyung Ho Kang, Hyun Kang, and Sung Jun Park have no conflicts of interest or financial ties to disclose. Ildong Pharmaceutical Company was not directly involved in the study design, data acquisition/interpretation, or manuscript preparation or review. Any opinions expressed herein do not necessarily reflect the opinions of Ildong Pharmaceutical Company.
- 19.Chen X, Thee C, Gruenewald M, Ilies C, Hocker J, Hanss R, Steinfath M, Bein B (2012) Correlation of surgical pleth index with stress hormones during propofol-remifentanil anaesthesia. Sci World J 2012:879158Google Scholar