title: Robotic thyroidectomy by bilateral axillo-breast approach: review of 1,026 cases and surgical completeness.
abstract: BACKGROUND
  Good postoperative and excellent cosmetic results have been achieved with bilateral axillo-breast approach (BABA) robotic thyroidectomy (RoT). This study was performed to analyze the surgical outcomes and evaluate the surgical completeness and safety of BABA RoT.
  
  
  METHODS
  Between February 2008 and February 2012, a total of 1026 cases of BABA RoT were performed. The clinicopathologic characteristics, operation types, and postoperative outcomes of patients were analyzed.
  
  
  RESULTS
  Of the 1026 cases analyzed, 968 cases were a malignant tumor and 58 cases were benign thyroid disease. Mean operating times for BABA total RoT with central lymph node dissection included 38 ± 13 min (range 20-90 min) of working space creation and 75 ± 26 min (range 25-175) of console time. Among the 872 patients who underwent total thyroidectomy with central lymph node dissection, transient hypoparathyroidism occurred in 39.1 %, transient vocal cord palsy occurred in 14.2 %, and permanent hypoparathyroidism and permanent vocal cord palsy occurred in 1.5 % and 0.2 % of patients, respectively. The median stimulated thyroglobulin (Tg) level of patients after their first radioactive iodine therapy was 0.4 ng/mL, with 65.1 % of patients having a stimulated Tg level of <1.0 ng/mL. The median suppressed Tg level at 3 postoperative months of patients without radioactive iodine therapy was <0.1 ng/mL, with 99.4 % of patients showing a suppressed Tg level of< 1.0 ng/mL. There was no recurrence or mortality after a median follow-up of 23 months.
  
  
  CONCLUSIONS
  BABA RoT is a safe and effective method that provides good surgical completeness and has low rates of postoperative complications and recurrence.
authors: Department of Surgery, Seoul National University Hospital and College of Medicine, 101, Daehak-ro, Jongno-gu, 110-744 Seoul, South Korea.
authors: Kyu Eun
authors: KE
authors: Lee
authors: Eunyoung
authors: E
authors: Kim
authors: Do Hoon
authors: do H
authors: Koo
authors: June Young
authors: JY
authors: Choi
authors: Kyu Hyung
authors: KH
authors: Kim
authors: Yeo-Kyu
authors: YK
authors: Youn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001365:Axilla; D001940:Breast; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult