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Transoral Robotic Thyroidectomy for Papillary Thyroid Carcinoma: Perioperative Outcomes of 100 Consecutive Patients

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Abstract

Background

Endoscopic transoral thyroidectomy is a recently introduced technique of remote access thyroidectomy. We previously reported the feasibility of the robotic approach (TORT). Nevertheless, experience to date is limited, with scant data on outcomes in patients with papillary thyroid carcinoma (PTC).

Methods

This was a retrospective analysis of prospectively collected data. Patients with PTC, who underwent TORT at a single center between March 2016 and February 2017, were analyzed.

Results

There were a total of 100 patients (85 women, 15 men) with a mean age of 40.7 ± 9.8 years, and a mean tumor size of 0.8 ± 0.5 cm. Nine patients underwent a total thyroidectomy, and 91 underwent a lobectomy. The operative time for a total thyroidectomy and lobectomy was 270.0 ± 9.3 and 210.8 ± 32.9 min, respectively. Ipsilateral prophylactic central neck compartment dissection was performed routinely with retrieval of 5.0 ± 3.6 lymph nodes. Perioperative morbidity was present in nine patients including transient recurrent laryngeal nerve palsy (n = 1), postoperative bleeding requiring surgical intervention (n = 1), zygomatic bruising (n = 2), chin flap perforation (n = 1), oral commissure tearing (n = 2), and chin dimpling (n = 2). There was no conversion to endoscopic or conventional open thyroid surgery.

Conclusion

In this study, TORT could be safely performed in a large series of patients with PTC without serious complications. In selected patients, TORT by experienced surgeons could be considered an alternative approach for remote access thyroidectomy.

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Abbreviations

TORT:

Transoral robotic thyroidectomy

PTC:

Papillary thyroid carcinoma

RLN:

Recurrent laryngeal nerve

VAS:

Visual analog scale

AJCC:

American Joint Committee on Cancer

CND:

Central neck dissection

TSH:

Thyroid stimulating hormone

Tg:

Thyroglobulin

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Acknowledgements

This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (Ministry of Science, ICT and Future Planning, NRF-2016R1E1A1A01942072) and by a grant of Korea University Anam Hospital, Seoul, Republic of Korea (Grant No. K1809811).

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Correspondence to Hoon Yub Kim.

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Hong Kyu Kim, Young Jun Chai, Gianlorenzo Dionigi, Eren Berber, Ralph P. Tufano, Hoon Yub Kim have no conflicts of interest or financial ties to disclose.

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Kim, H.K., Chai, Y.J., Dionigi, G. et al. Transoral Robotic Thyroidectomy for Papillary Thyroid Carcinoma: Perioperative Outcomes of 100 Consecutive Patients. World J Surg 43, 1038–1046 (2019). https://doi.org/10.1007/s00268-018-04877-w

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