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Bilateral axillo-breast approach robotic thyroidectomy in pediatric patients with thyroid disease and cancer

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Abstract

Purpose

Robotic thyroid surgeries have cosmetic advantages over open surgeries, which are especially important in pediatric patients due to social stigmas from neck scars. The present study describes outcomes in a series of children who underwent bilateral axillo-breast approach (BABA) robotic thyroidectomy.

Methods

Pediatric patients aged ≤18 years who underwent BABA robotic thyroidectomy between 2014 and 2022 were retrospectively reviewed. Their clinical characteristics and surgical outcomes were evaluated. Surgical completeness was determined by comparing the number of retrieved lymph nodes per compartment to previously reported lymph node quantification.

Results

This study included 26 pediatric patients of mean age 15.5 years (range, 5–18 years). Of these 26 patients, 21 (80.8%) had thyroid cancer, with 9 (42.9%) having aggressive tumor pathology. The mean operation time was 157.3 min. No patient needed open conversion. Five patients (19.2%) experienced complications including transient hypoparathyroidism (n = 5), permanent hypoparathyroidism (n = 2), and chyle leakage (n = 1), but none experienced vocal cord palsy. The mean numbers of retrieved lymph nodes at levels IIa, III, IV, Vb, and VI were 3.2, 4.1, 5.6, 1.0, and 9.7, respectively, numbers comparable with the known quantification except for level II, as IIb dissection was omitted in our series.

Conclusion

BABA robotic thyroidectomy is safe and effective in pediatric patients with thyroid diseases. Most complications were minor and transient, with the operation time similar to robotic thyroidectomy in adults. Surgical completeness was also satisfactory. Robotic thyroidectomy can be considered a surgical option, regardless of patient age or diagnosis.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea

    Ja Kyung Lee, Jee-Hye Choi, Woochul Kim, Hyeong Won Yu & June Young Choi

  2. Department of Surgery, Icahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, NY, USA

    Jee-Hye Choi

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

    JungHak Kwak, Su-jin Kim & Kyu Eun Lee

  4. Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea

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

  5. Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, South Korea

    Young Jun Chai

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Contributions

J.K.L.: Writing - Original Draft, Writing - Review & Editing; J.H.C.: Data Curation; W.K.: Data Curation; J.K.: Formal analysis; H.W.Y.: Formal analysis, Conceptualization; S.J.K.: Methodology; Y.J.C.: Methodology; J.Y.C.: Project administration, Supervision, Conceptualization; K.E.L.: Supervision, Conceptualization.All authors read and approved the final manuscript.

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Correspondence to June Young Choi.

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Lee, J.K., Choi, JH., Kim, W. et al. Bilateral axillo-breast approach robotic thyroidectomy in pediatric patients with thyroid disease and cancer. Endocrine 81, 532–539 (2023). https://doi.org/10.1007/s12020-023-03372-0

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  • DOI: https://doi.org/10.1007/s12020-023-03372-0

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