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Comparison of Bilateral Axillo-Breast Approach Robotic Thyroidectomy with Open Thyroidectomy for Graves’ Disease

  • Surgical Symposium Contribution
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Abstract

Background

There is an ongoing debate about whether robotic thyroidectomy (RT) is appropriate for Graves’ disease. The aim of this study was to compare the safety of bilateral axillo-breast approach (BABA) RT with that of open thyroidectomy (OT) in patients with Graves’ disease.

Methods

From January 2008 to June 2014, 189 (44 BABA RT and 145 OT) patients underwent total thyroidectomy for Graves’ disease. Recurrence of Graves’ disease, intraoperative blood loss, hospital stay, and complication rates including recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism were analyzed between BABA RT and OT groups, after propensity score matching according to age, gender, body mass index, surgical indication, the extent of operation, excised thyroid weight, and follow-up period.

Results

No patient experienced recurrence of Graves’ disease after median follow-up of 35.0 months. Intraoperative blood loss (151.8 ± 165.4 mL vs. 134.5 ± 75.4 mL; p = 0.534) and hospital stay (3.4 ± 0.7 day vs. 3.3 ± 0.7 day; p = 0.564) were not different between BABA RT and OT groups. Complication rates including transient RLN palsy (11.4 vs. 11.4 %; p = 1.000), transient hypoparathyroidism (18.2 vs. 20.5 %; p = 0.787), permanent RLN palsy (0 vs. 2.3 %; p = 0.315), and permanent hypoparathyroidism (2.3 vs. 2.3 %; p = 1.000) were also comparable between groups.

Conclusions

BABA RT for Graves’ disease showed comparable surgical completeness and complications to conventional OT. BABA RT can be recommended as an alternative surgical option for patients with Graves’ disease who are concerned about cosmesis.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Hyungju Kwon, Jin Wook Yi, Ra-Yeong Song, Su-jin Kim & Kyu Eun Lee

  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Hyungju Kwon

  3. Department of Surgery, Seoul National University Boramae Hospital, Seoul, Korea

    Young Jun Chai

  4. Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea

    June Young Choi

Authors
  1. Hyungju Kwon
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  2. Jin Wook Yi
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Correspondence to Hyungju Kwon.

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Disclosure

Drs. Kwon, Yi, Song, Chai, Kim, Choi, and Lee have no conflicts of interest or financial ties to disclose.

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Kwon, H., Yi, J.W., Song, RY. et al. Comparison of Bilateral Axillo-Breast Approach Robotic Thyroidectomy with Open Thyroidectomy for Graves’ Disease. World J Surg 40, 498–504 (2016). https://doi.org/10.1007/s00268-016-3403-7

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  • DOI: https://doi.org/10.1007/s00268-016-3403-7

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