Surgical safety and oncological completeness of robotic thyroidectomy for thyroid carcinoma larger than 2 cm
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The safety of robotic thyroidectomy (RT) for small-sized thyroid carcinomas has been well established. The surgical outcomes of bilateral axillo-breast approach RT for thyroid carcinomas larger than 2 cm were evaluated and compared with those of open thyroidectomy (OT).
The medical records of patients who underwent total thyroidectomy or hemithyroidectomy followed by completion thyroidectomy for differentiated thyroid carcinomas measuring 2–4 cm were retrospectively reviewed.
The study included 86 patients who underwent RT (n = 21) or OT (n = 65) with mean ages of 30.8 and 51.6 years, respectively. The mean tumor size was 2.8 cm in both groups. There were no significant differences between the RT and OT groups in vocal cord palsy rate (transient, 19.0 vs. 9.2 %; permanent, 0 vs. 1.5 %), postoperative hypoparathyroidism rate (transient, 19.0 vs. 33.8 %; permanent, 4.8 vs. 1.5 %), and the number of retrieved central lymph nodes in papillary thyroid carcinoma patients (6.4 ± 3.5 vs. 6.1 ± 3.9, respectively). The proportion of the patients with serum stimulated thyroglobulin level of <1.0 ng/ml at the initial radioactive iodine treatment was 64.7 % (11/17) for RT group and 66.0 % (35/53) for OT group (p = 0.920). There were three patients (1 RT and 2 OT) who had a biochemical incomplete response, and there was no case of anatomical recurrence or mortality during the median follow-up period of 40.2 months.
RT is a safe and oncologically sound treatment option for differentiated thyroid carcinomas measuring 2–4 cm in a selected group of patients. The role of RT should be evaluated in correlation with technological advances and increased experience.
KeywordsRobotic Thyroidectomy Bilateral axillo-breast approach BABA Completeness Large thyroid carcinoma
This study was funded by the Korean Foundation for Cancer Research (Grant Number CB-2011-03-01), and the Ministry of Science, ICT and Future Planning, Republic of Korea (Grant Number 2015R1C1A1A01055464).
Compliance with ethical standards
Young Jun Chai, Hyunsuk Suh, Jung-Woo Woo, Hyeong Won Yu, Ra-Yeong Song, Hyungju Kwon, and Kyu Eun Lee have no conflicts of interest or financial ties to disclose.
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