title: Robot-assisted neck dissection via a transaxillary and retroauricular approach versus a conventional transcervical approach in papillary thyroid cancer with cervical lymph node metastases.
abstract: BACKGROUND
  Recently, robot-assisted neck dissection (ND) using a transaxillary approach in thyroid cancer patients with lateral neck metastases (LNM) was demonstrated to be feasible. The aim of this study was to compare the surgical outcomes of a modified transaxillary and retroauricular (TARA) versus a conventional transcervical approach in papillary thyroid carcinoma (PTC) patients with LNM.
  
  
  METHODS
  In total, 47 patients with PTC underwent total thyroidectomy with central compartment ND and modified radical ND except Level I. Twenty-two NDs were performed via the TARA approach, and 25 unilateral NDs were performed via the conventional transcervical approach.
  
  
  RESULTS
  The TARA and the open ND groups consisted of 22 and 25 patients, respectively. The operation time for ND in the TARA group was longer than that in the open ND group (209.4±38.2 minutes versus 143.1±30.5 minutes; P=.000). The mean scar satisfaction score in the TARA group was higher than in the conventional ND group (3.9±1.0 versus 2.8±1.0; P=.000). There were no differences in the mean number of retrieved lymph nodes.
  
  
  CONCLUSIONS
  The robot-assisted ND via the TARA approach can be an alternative option that produces excellent esthetic results for the management of LNM in PTC patients.
authors.affiliation: 1 Department of Otorhinolaryngology, Yonsei University College of Medicine , Seoul, Korea.
authors.forename: Won Shik
authors.initials: WS
authors.lastname: Kim
authors.forename: Yoon Woo
authors.initials: YW
authors.lastname: Koh
authors.forename: Hyung Kwon
authors.initials: HK
authors.lastname: Byeon
authors.forename: Young Min
authors.initials: YM
authors.lastname: Park
authors.forename: Hyo Jin
authors.initials: HJ
authors.lastname: Chung
authors.forename: Eun Sung
authors.initials: ES
authors.lastname: Kim
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Lee
authors.forename: Sang Chul
authors.initials: SC
authors.lastname: Park
authors.forename: Eun Chang
authors.initials: EC
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects / Q000379:methods*; D061646:Operative Time; D056910:Republic of Korea; D065287:Robotic Surgical Procedures / Q000379:methods*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome