Technical and oncologic safety of robotic thyroid surgery

Abstract

Background: The aim of this study was to evaluate the surgical outcomes of a double-incision robot-assisted gasless transaxillary thyroidectomy procedure compared with conventional open thyroid surgery.

Methods: We enrolled and analyzed 521 female patients with classic papillary thyroid carcinoma (PTC) who underwent a total thyroidectomy with central compartment node dissection (CCND) at the Asan Medical Center in Seoul, Korea from December 2008 to December 2010. These patients were classified into robotic (N = 98) or open (N = 423) groups and were compared with respect to clinicopathologic characteristics, complications, and stimulated thyroglobulin (sTg) levels at the time of immediate postoperative radioactive iodine remnant ablation (ablation sTg) and at 6-12 months after the first ablation (control sTg).

Results: The rate of perioperative complications was also similar, except for transient hypoparathyroidism in the robotic group. The median ablation sTg levels (0.39 vs 0.50 ng/mL, P = 0.215) and the proportion of patients with ablation sTg levels <10 ng/mL (94.5 vs 98.0 %, P = 0.103) were also comparable between the robotic and open groups. In addition, the proportion of patients with control sTg levels <1 ng/mL in both robotic and open groups (91.3 vs 95.6 %, P = 0.079) did not show a significant difference.

Conclusions: Robotic thyroid surgery using a double-incision gasless transaxillary approach is technically safe and may provide a feasible option for a complete thyroid resection and adequate lymph node dissection in patients with PTC.