Comparison of Robotic versus Conventional Lateral Neck Dissection for Differentiated Thyroid Carcinoma

Abstract

Objectives: In advances in robotic thyroidectomy, we have performed robotic lateral neck dissection by a gasless unilateral axillo-breast (GUAB) or axillary (GUA) approach for differentiated thyroid carcinoma (DTC) to avoid long visible scars in the neck. The aim of this study is to evaluate technical feasibility and efficacy of robotic lateral neck dissection compared with conventional neck dissection. Methods: We studied 72 patients with DTC who underwent total thyroidectomy with robotic selective neck dissection by GUAB or GUA approach (23 cases) or conventional open neck dissection (49 cases) in the unilateral neck between January 2010 and July 2013. Results: The mean age and body mass index was lower, and female sex was more common in the robotic group compared with the open group ( P < .05). Stage was more advanced in the open group ( P < .05). The mean total operative time was significantly longer in the robotic group (319 ± 65 minutes) than the conventional group (214 ± 110 minutes; P < .001). The mean number of lymph nodes removed in the lateral compartment was not different between the 2 groups (24.7 ± 11.3 in the robotic group and 30.9 ± 17.7 in the conventional group, P = .091). The postoperative complication did not differ between the 2 groups. Postoperative cosmetic satisfaction was superior in the robotic group than the conventional group ( P < .05). Conclusions: Robotic lateral selective neck dissection by GUAB or GUA approach is comparable to conventional lateral neck dissection in selected patients with DTC and provides better postoperative cosmesis than conventional neck dissection.