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Safety and Feasibility of Robotic Transaxillary Thyroidectomy for Graves’ Disease: A Retrospective Cohort Study

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A Correction to this article was published on 26 March 2022

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Abstract

Background

Despite the increase in experience and understanding of robotic thyroidectomy, its application for Graves’ disease (GD) remains controversial. This study aimed to assess the safety and feasibility of robotic transaxillary thyroidectomy (RTT) for GD in comparison with the conventional open thyroidectomy (open group: OG) approach.

Methods

A total of 192 patients who underwent surgical resection for GD were retrospectively reviewed. Among them, 51 patients underwent RTT and the remaining 141 patients were in the conventional OG.

Results

All robotic operations were performed successfully without open conversion. Patients who underwent RTT were significantly younger (P < 0.001) and predominantly of the female sex. Operative time was longer for RTT than for the OG (182.5 ± 58.1 vs. 112.0 ± 29.5; P < 0.001). The mean intraoperative blood loss was not statistically different between RTT and the OG (113.3 ± 161.6 vs. 95.3 ± 209.1, P = 0.223). The mean weight of the resected thyroid was reduced in those who underwent RTT compared with open thyroidectomy (P = 0.033). The overall complication rate for RTT and open thyroidectomy was not significantly different (33.3% vs. 22.7%, P = 0.135). In RTT, the most common complication was transient hypocalcemia (21%). Permanent hypocalcemia and recurrent laryngeal nerve injury occurred in only one patient in each group. The weight of the resected thyroid was not related to the incidence of complications in patients receiving RTT.

Conclusions

Considering excellent cosmesis, findings of this study support the safety and feasibility of RTT. Nevertheless, it should be performed by expert surgeons with extensive robotic surgery experience.

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Acknowledgements

The authors thank the Robot team in our center, especially Ho Young Kim and Hee Chang Yu, for their technical support.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Corresponding author

Correspondence to Woong Youn Chung.

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The authors declare that they have no conflict of interest.

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The requirement for informed consent was waived owing to the retrospective nature of this study.

Human and animal rights

This study was approved by the Yonsei University institutional review board of our institution (IRB No. 4–2020-1343).

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The original online version of this article was revised: Co-authorship note for Mohammed Saad Bu Bshait and Jin Kyong Kim was added.

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Bu Bshait, M.S., Kim, J.K., Lee, C.R. et al. Safety and Feasibility of Robotic Transaxillary Thyroidectomy for Graves’ Disease: A Retrospective Cohort Study. World J Surg 46, 1107–1113 (2022). https://doi.org/10.1007/s00268-021-06430-8

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