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. 2014 Nov;21(12):3859-64.
doi: 10.1245/s10434-014-3838-8. Epub 2014 Jun 17.

Robotic thyroidectomy for cancer in the US: patterns of use and short-term outcomes

Mohamed Abdelgadir Adam  1 , Paul Speicher, John Pura, Michaela A Dinan, Shelby D Reed, Sanziana A Roman, Julie A Sosa
Affiliations

Robotic thyroidectomy for cancer in the US: patterns of use and short-term outcomes

Mohamed Abdelgadir Adam et al. Ann Surg Oncol. 2014 Nov.

Abstract

Background: We describe nationally representative patterns of utilization and short-term outcomes from robotic versus open thyroidectomy for thyroid cancer.

Methods: Descriptive statistics and multivariable analysis were used to analyze patterns of use of robotic thyroidectomy from the National Cancer Database (2010-2011). Short-term outcomes were compared between patients undergoing robotic versus open thyroidectomy, while adjusting for confounders.

Results: A total of 68,393 patients with thyroid cancer underwent thyroidectomy; 225 had robotic surgery and 57,729 underwent open surgery. Robotic thyroid surgery use increased by 30 % from 2010 to 2011 (p = 0.08). Robotic cases were reported from 93 centers, with 89 centers performing <10 robotic cases. Compared with the open group, the robotic group was younger (51 vs. 47 years; p < 0.01) and included more Asian patients (4 vs. 8 %; p = 0.006) and privately-insured patients (68 vs. 77 %; p = 0.01). Tumor size was similar between patients undergoing robotic versus open surgery. Total thyroidectomy was performed less frequently in the robotic group (67 vs. 84 % open; p < 0.0001). Patients were relatively more likely to undergo robotic surgery if they were female (odds ratio [OR] 1.6; p = 0.04), younger (OR 0.8/10 years; p < 0.0001), or underwent lobectomy (OR 2.4; p < 0.0001). In adjusted multivariable analysis, there were no differences in the number of lymph nodes removed or length of stay between groups; however, there was a non-significant increase in the incidence of positive margins with robotic thyroidectomy.

Conclusions: Use of robotic thyroidectomy for thyroid cancer is limited to a few institutions, with short-term outcomes that are comparable to open surgery. Multi-institutional studies should be undertaken to compare thyroidectomy-specific complications and long-term outcomes.

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Figures

FIG. 1
FIG. 1
Variation in robotic thyroidectomy case volume among hospitals performing robotic cases for thyroid cancer (2010–2011)
FIG. 2
FIG. 2
Summary of the distribution of hospitals performing robotic thyroidectomy and corresponding robotic cases in the three robotic volume categories; hospitals in the top two volume categories (four hospitals) performed 30 % of all robotic cases for cancer (2010–2011)
See this image and copyright information in PMC

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