A comparative study of the surgical outcomes of robotic and conventional open modified radical neck dissection for papillary thyroid carcinoma with lateral neck node metastasis.
BACKGROUND
Several endoscopic modified radical neck dissections (MRND) have been conducted since the introduction of the endoscopic technique to thyroid surgery with the aim of avoiding a long cervical scar. Furthermore, the recent introduction of surgical robotic systems has increased the precision of endoscopic techniques. The aim of this study was to evaluate and compare the early surgical outcomes of robotic and conventional open MRND for papillary thyroid carcinoma (PTC) with lateral neck node metastasis (LNM).


METHODS
From January 2009 to May 2010, 165 patients with PTC underwent bilateral total thyroidectomy with central compartment neck dissection and ipsilateral MRND. Of these patients, 56 formed the robotic procedure group (RG) and 109 the conventional open procedure group. These two groups were retrospectively compared with respect to their clinicopathological characteristics, early surgical outcomes, and surgical completeness.


RESULTS
The operative time was longer, mean tumor size was smaller, mean age was lower, and disease stage was earlier in the RG. However, mean numbers of retrieved lymph nodes were similar in the two groups, and mean hospital stay after surgery was shorter in the RG. Furthermore, complication rates were similar in the two groups, and there was no statistical difference in postoperative Tg levels between the groups.


CONCLUSIONS
Robotic MRND was found to be similar to conventional open MRND in terms of early surgical outcomes and surgical completeness but leaves no scar on the neck area. Robotic MRND can be viewed as an acceptable alternative method in low-risk PTC with LNM.
Department of Surgery, Yonsei University College of Medicine, C.P.O. Box 8044, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. oralvanco@yuhs.ac
Sang-Wook
SW
Kang
So Hee
SH
Lee
Jae Hyun
JH
Park
Jun Soo
JS
Jeong
Seulkee
S
Park
Cho Rok
CR
Lee
Jong Ju
JJ
Jeong
Kee-Hyun
KH
Nam
Woong Youn
WY
Chung
Cheong Soo
CS
Park
D000328:Adult; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D004867:Equipment Design; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012371:Robotics; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome