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A Time Trend Analysis of 5,000 Robotic Thyroidectomies via Bilateral Axillo-Breast Approach

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Abstract

Background

This study aimed to investigate the time trends of surgical outcomes in patients who underwent bilateral axillo-breast approach robotic thyroidectomy (BABA RT) over the last 14 years.

Methods

From February 2008 to September 2021, we conducted a retrospective medical chart review of 5,011 consecutive patients who underwent BABA RT at three Seoul National University-affiliated hospitals. The patients were divided into three groups based on the main model of the da Vinci robotic surgical system to evaluate trends in surgical treatment strategies and outcomes after BABA RT.

Results

Of the 5,011 patients (4,706 malignant and 305 benign), the most common histological subtype was papillary thyroid carcinoma (n = 4,584; 97.4%). The mean tumor size significantly increased from 0.8 cm to 1.2 cm (p < 0.05). The mean numbers of metastatic and harvested lymph nodes from the central neck dissection and the lateral neck dissection showed a significant difference and tendency to increase (from 0.9 to 1.6, 4.7 to 6.2, p < 0.05, and from 0.6 to 3.9, 5.3 to 17.9, p < 0.05), respectively, throughout the study period. Permanent hypoparathyroidism decreased from 3.4 to 2.9%. The rate of transient and permanent vocal cord palsy decreased from 15.2 to 2.7% and from 0.7 to 0.2%, respectively.

Conclusion

With advancements in robotic surgical systems and improvements in the BABA RT technique, surgical indications have expanded to include more advanced thyroid diseases, and surgical outcomes have improved over the last 14 years.

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Acknowledgements

We acknowledge Woochul Kim, Hyeonuk Hwang, Seonghoon Kim, and Ah Jung Seo for their dedicated effort in the data acquisition of this study.

Funding

This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project Number:KMDF_PR_20200901_0146), MSIT(Ministry of Science and ICT), Korea, under the ITRC(Information Technology Research Center) support program(IITP-2021–2018-0–01833) supervised by the IITP(Institute for Information & Communications Technology Planning & Evaluation), and Institute of Information & communications Technology Planning & Evaluation (IITP) grant funded by the Korea government(MSIT) (No. 2021–0-0052, Cloud-based XR content conversion and service technology development that changes according to device performance).

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Author notes

  1. JungHak Kwak, Hyeong Won Yu have contributed equally to this work and are considered to be co-first authors.

Authors and Affiliations

  1. Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea

    JungHak Kwak, Jong-hyuk Ahn, Su-jin Kim & Kyu Eun Lee

  2. Department of Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea

    Hyeong Won Yu & June Young Choi

  3. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

    JungHak Kwak, Hyeong Won Yu, Su-jin Kim, Young Jun Chai, June Young Choi & Kyu Eun Lee

  4. Department of Surgery, Chungbuk National University Hospital, Cheongju, Republic of Korea

    Jong-hyuk Ahn

  5. Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea

    Su-jin Kim & Kyu Eun Lee

  6. Medical Big Data Research Center, Institute of Medical and Biological Engineering, Seoul National University, Seoul, Republic of Korea

    Kyu Eun Lee

  7. Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Republic of Korea

    Young Jun Chai

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  1. JungHak Kwak
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Corresponding authors

Correspondence to June Young Choi or Kyu Eun Lee.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was exempted by the Institutional Review Board of Seoul National University-affiliated hospitals due to the retrospective nature of this study.

Human and animal rights

This study was approved by the Institutional Review Board of Seoul National University Hospital (IRB number: 2110-189-1267), Seoul National University Bundang Hospital (IRB number: 2208-772-403), and Seoul National University Boramae Medical Center (IRB number: 10-2022-72).

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Kwak, J., Yu, H.W., Ahn, Jh. et al. A Time Trend Analysis of 5,000 Robotic Thyroidectomies via Bilateral Axillo-Breast Approach. World J Surg 47, 403–411 (2023). https://doi.org/10.1007/s00268-022-06836-y

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