title: Robot-assisted transaxillary thyroid surgery in the United States: is it comparable to open thyroid lobectomy?
abstract: BACKGROUND
  The purpose of this study was to compare the outcome of robot-assisted transaxillary thyroid surgery (RATS) to the standard open technique for thyroid lobectomy in the U.S. population.
  
  
  METHODS
  Comparison was made between 25 consecutive patients who underwent thyroid lobectomy via RATS and 25 patients who underwent open thyroid lobectomy. All patients met predetermined criteria for RATS. Clinical characteristics of patients and operative data were compared between groups using the Fisher exact or the Kruskal-Wallis test.
  
  
  RESULTS
  The RATS and open groups were similar in gender (92% vs 84% female), median body mass index (BMI) (25 vs 26), preoperative cytology (P=.71), and postoperative diagnosis (P=.91). Operative time for the RATS group was longer than the open group [median 121 minutes (range 74-199 minutes) vs 68 minutes (41-112 minutes), P<.0001]. Estimated blood loss was greater in the RATS group [median 10 cc (0-150 cc) vs 0 cc (0-25 cc), P=.0042]. Unlike the open group, postoperative complications in the RATS group included 2 patients with neurological deficits in the brachial plexus distribution. The postoperative incidence of temporary hoarseness, bleeding, infection, seroma, numbness, and length of hospital stay did not differ significantly between groups.
  
  
  CONCLUSIONS
  In a select group of patients, RATS is comparable to open thyroid lobectomy in terms of postoperative complications and hospital stay. Patients should be counseled that RATS is associated with a longer operative time, a potential for brachial plexus neurological deficits, and larger (although still low) blood loss. A prospective trial further evaluating cost, quality of life, and patient-reported satisfaction is warranted.
authors: Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
authors: Christine S
authors: CS
authors: Landry
authors: Elizabeth G
authors: EG
authors: Grubbs
authors: Carla L
authors: CL
authors: Warneke
authors: Mandy
authors: M
authors: Ormond
authors: Cindy
authors: C
authors: Chua
authors: Jeffrey E
authors: JE
authors: Lee
authors: Nancy D
authors: ND
authors: Perrier
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000601:surgery; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012086:Reoperation; D012189:Retrospective Studies; D012371:Robotics; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult