title: Predictive factors for difficult robotic thyroidectomy using the bilateral axillo-breast approach.
abstract: The purpose of this study was to identify predictors of difficult robotic thyroidectomy using the bilateral axillo-breast approach (BABA) for the management of patients with papillary thyroid carcinoma (PTC).
  
  
  
  We examined a database containing details of patients with PTC who had undergone robotic thyroidectomy with cervical lymph node dissection between July 2008 and June 2013. Patients were subgrouped into difficult thyroidectomy and non-difficult thyroidectomy to identify predictors associated with difficult thyroidectomy corresponding to the time of operation. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were investigated.
  
  
  
  Male sex was the only significantly different clinicopathologic factor between the 2 groups (p = .013). Other factors, such as age (p = .809) and body mass index (BMI; p = .202), were comparable between the 2 groups. The rates of postoperative complications, such as hypoparathyroidism, vocal cord palsy, and seroma, in the difficult thyroidectomy group were not significantly different from those in the non-difficult thyroidectomy group. There was no hematoma or wound infection. Male sex was the only independent factor associated with difficult thyroidectomy (odds ratio [OR] = 5.379; 95% confidence interval [CI] = 1.052-27.502; p = .043), according to the multivariate logistic regression model.
  
  
  
  Male sex was the only predictive factor for difficult robotic thyroidectomy using BABA. Further evaluations should be performed to ascertain additional factors associated with difficult robotic thyroidectomy. © 2015 Wiley Periodicals, Inc. Head Neck 38: E954-E960, 2016.
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hee Yong
authors.initials: HY
authors.lastname: Kwak
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hoon Yub
authors.initials: HY
authors.lastname: Kim
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hye Yoon
authors.initials: HY
authors.lastname: Lee
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seung Pil
authors.initials: SP
authors.lastname: Jung
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sang Uk
authors.initials: SU
authors.lastname: Woo
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Gil Soo
authors.initials: GS
authors.lastname: Son
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Bok
authors.initials: JB
authors.lastname: Lee
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jeoung Won
authors.initials: JW
authors.lastname: Bae
mesh_terms: D000328:Adult; D001365:Axilla; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D012189:Retrospective Studies; D012307:Risk Factors; D065287:Robotic Surgical Procedures; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
keywords: bilateral axillo-breast approach; difficulty; papillary thyroid carcinoma; robotic thyroidectomy; thyroiditis