Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach.
BACKGROUND
We developed the bilateral, axillo-breast approach (BABA) to endoscopic thyroidectomy and applied it to the da Vinci robotic surgical system in 2008. Herein, we have analyzed the immediate postoperative outcomes and 1-year follow-up results of robotic BABA total thyroidectomy with central node dissection (CND).


METHODS
In 2008 and 2009, 109 patients with PTC underwent robotic BABA total thyroidectomy with CND. Clinicopathologic characteristics, short- and long-term complications, and postoperative thyroglobulin (Tg) level were obtained prospectively and analyzed.


RESULTS
The mean age was 39 ± 10 years and the male to female ratio was 1:5.8. The mean operation time was 206 ± 36 minutes. Transient recurrent laryngeal nerve (RLN) palsy occurred in 17 cases (16%) and transient hypocalcemia in 21 cases (19%). The median follow-up was 12 months. There were 1 and 2 cases of permanent RLN palsy and permanent hypoparathyroidism, respectively. Postoperative radioactive iodine ablation was performed on 54 patients (50%). Their mean stimulated Tg level was 1.84 ± 6.35 ng/mL and 76% had stimulated Tg levels <1.0 ng/mL.


CONCLUSIONS
Robotic BABA total thyroidectomy with CND yields good postoperative outcomes. Given the excellent cosmetic outcomes, this technique may be a suitable operative alternative for low-risk patients with PTC.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Kyu Eun
KE
Lee
Do Hoon
do H
Koo
Su-Jin
SJ
Kim
Jeonghun
J
Lee
Kyoung Sik
KS
Park
Seung Keun
SK
Oh
Yeo-Kyu
YK
Youn
D000293:Adolescent; D000328:Adult; D000368:Aged; D001365:Axilla / Q000601:surgery; D001940:Breast; D002277:Carcinoma; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007723:Korea; D007823:Laryngeal Nerves / Q000473:pathology; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010243:Paralysis / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D012371:Robotics / Q000379:methods*; D013954:Thyroglobulin / Q000097:blood; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D013954:Thyroglobulin