title: Comparison of Bilateral Axillo-Breast Approach Robotic Thyroidectomy with Open Thyroidectomy for Graves' Disease.
abstract: BACKGROUND
  There is an ongoing debate about whether robotic thyroidectomy (RT) is appropriate for Graves' disease. The aim of this study was to compare the safety of bilateral axillo-breast approach (BABA) RT with that of open thyroidectomy (OT) in patients with Graves' disease.
  
  
  METHODS
  From January 2008 to June 2014, 189 (44 BABA RT and 145 OT) patients underwent total thyroidectomy for Graves' disease. Recurrence of Graves' disease, intraoperative blood loss, hospital stay, and complication rates including recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism were analyzed between BABA RT and OT groups, after propensity score matching according to age, gender, body mass index, surgical indication, the extent of operation, excised thyroid weight, and follow-up period.
  
  
  RESULTS
  No patient experienced recurrence of Graves' disease after median follow-up of 35.0 months. Intraoperative blood loss (151.8 ± 165.4 mL vs. 134.5 ± 75.4 mL; p = 0.534) and hospital stay (3.4 ± 0.7 day vs. 3.3 ± 0.7 day; p = 0.564) were not different between BABA RT and OT groups. Complication rates including transient RLN palsy (11.4 vs. 11.4%; p = 1.000), transient hypoparathyroidism (18.2 vs. 20.5%; p = 0.787), permanent RLN palsy (0 vs. 2.3%; p = 0.315), and permanent hypoparathyroidism (2.3 vs. 2.3%; p = 1.000) were also comparable between groups.
  
  
  CONCLUSIONS
  BABA RT for Graves' disease showed comparable surgical completeness and complications to conventional OT. BABA RT can be recommended as an alternative surgical option for patients with Graves' disease who are concerned about cosmesis.
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. lovekkung@gmail.com.|Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. lovekkung@gmail.com.
authors.forename: Hyungju
authors.initials: H
authors.lastname: Kwon
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Yi
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Ra-Yeong
authors.initials: RY
authors.lastname: Song
authors.affiliation: Department of Surgery, Seoul National University Boramae Hospital, Seoul, Korea.
authors.forename: Young Jun
authors.initials: YJ
authors.lastname: Chai
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea.
authors.forename: Su-jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital and College of Medicine, Seongnam, Korea.
authors.forename: June Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea. kyueunlee@snu.ac.kr.
authors.forename: Kyu Eun
authors.initials: KE
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001365:Axilla; D001940:Breast; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D057216:Propensity Score; D012008:Recurrence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D013965:Thyroidectomy / Q000379:methods*; D055815:Young Adult