Surgical completeness of robotic thyroidectomy: a prospective comparison with conventional open thyroidectomy in papillary thyroid carcinoma patients.
BACKGROUND
Using the da Vinci(®) robotic system, surgeons can complete secure thyroidectomy without noticeable neck scarring. This study compared the surgical completeness of transaxillary robotic thyroidectomy (RT) with conventional open procedures (OT) in treating papillary thyroid carcinoma (PTC) patients.


METHODS
From April 2009 through February 2011, 94 PTC patients underwent total thyroidectomy with central compartment neck dissection (CCND) at Yonsei University College of Medicine. All patients received 1.1 GBq radioactive iodine (RAI) ablation, post-therapy whole-body scans (TxWBS), and diagnostic WBS (DxWBS) 1 year later. We prospectively compared patient clinicopathologic characteristics and surgical completeness between the two groups.


RESULTS
Fifty-one patients underwent OT and 43 underwent RT. Mean age was significantly younger in the RT group. Tumor size, capsular-invasion frequency, multifocality, bilaterality, and central nodal metastasis were not different between the two groups. The number of retrieved nodes during CCND did not significantly differ between the groups. There was no significant difference between the OT and RT groups in stimulated thyroglobulin levels acquired during TxWBS and DxWBS. The RAI uptake ratios at TxWBS were significantly higher in the RT group compared with the OT group; however, follow-up DxWBS showed no difference in RAI uptake ratios. Also, the ablation success rate was similar between the two groups. There were no abnormal findings in follow-up neck ultrasonography in either group.


CONCLUSIONS
Remnant thyroid tissue ablation after transaxillary RT was successfully managed by 1.1 GBq RAI. RT showed similar surgical completeness versus conventional OT, and provides a safe and feasible surgical option for PTC patients.
Department of Surgery, College of Medicine, Catholic University of Korea, Seoul, Korea, leesohee@catholic.ac.kr.
Sohee
S
Lee
Cho Rok
CR
Lee
Seung Chul
SC
Lee
Seulkee
S
Park
Ha Yan
HY
Kim
Haiyoung
H
Son
Sang-Wook
SW
Kang
Jong Ju
JJ
Jeong
Kee-Hyun
KH
Nam
Woong Youn
WY
Chung
Cheong Soo
CS
Park
Arthur
A
Cho
D000328:Adult; D001365:Axilla; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012371:Robotics / Q000379:methods*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000379:methods