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Comparison of surgical completeness in patients operated on conventional open total thyroidectomy (OT) or trans-axillary robot-assisted total thyroidectomy (RATT) by a single axillary approach

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Abstract

Trans-axillary robot-assisted total thyroidectomy (RATT) is nowadays worldwide accepted but the completeness obtained by RATT is still debated. The Aim of this study was to compare the completeness and safety of RATT with conventional open thyroidectomy (OT). We enrolled patients with nontoxic multinodular goiter, cytologically indeterminate nodules and well differentiated thyroid cancer without local and/or distant metastasis. In all cases the biggest nodule should be < 6 cm. The surgical completeness was evaluated by means of serum thyroglobulin (hs-Tg) and neck ultrasound (nUS) performed three months postoperatively. 100 patients underwent either RATT or OT. The type of surgical procedure was chosen by patients. They were then divided in two subgroups based on benign or malignant histology. There were no significant differences in the postoperatively values of hs-Tg in patients operated with RATT or OT, both in benign and malignant subgroups. The post-operative thyroid remnant volume estimated by nUS was not significantly different between the two groups, both in benign and malignant subgroups. We also analyzed the difference of the volume of the thyroid remnant ipsilateral to the axillary access vs that of the remnant on the contralateral side and there was not significantly difference in both subgroups. RATT was demonstrated to determine a comparable surgical completeness as OT, both in benign and malignant thyroid diseases, with no differences in the prevalence of surgical complications. In our hands the surgical completeness of RATT by a single trans-axillary was satisfying.

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The authors have no relevant financial or non financial interests to disclose.

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Authors and Affiliations

  1. Department of Surgical, Medical, Molecular Pathology and Critical Area, Endocrine Surgery Unit, Pisa University Hospital, Via Paradisa 2, Edificio 30 E, 56100, Pisa, Italy

    Valeria Matteucci, Lorenzo Fregoli, Piermarco Papini, Leonardo Rossi & Gabriele Materazzi

  2. Department of Clinical and Experimental Medicine, Endocrine Unit, Pisa University Hospital, Pisa, Italy

    Antonio Matrone & Rossella Elisei

  3. Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa, Italy

    Mario Miccoli

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  1. Valeria Matteucci
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  2. Lorenzo Fregoli
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  5. Antonio Matrone
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  6. Mario Miccoli
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performend by Valeria Matteucci and Antonio Matrone, analysis were performed by Mario Miccoli. The first draft of the manuscript was written by Valeria Matteucci and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Valeria Matteucci.

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Matteucci, V., Fregoli, L., Papini, P. et al. Comparison of surgical completeness in patients operated on conventional open total thyroidectomy (OT) or trans-axillary robot-assisted total thyroidectomy (RATT) by a single axillary approach. Updates Surg 75, 1267–1275 (2023). https://doi.org/10.1007/s13304-023-01510-x

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