Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach

Abstract

We developed the bilateral, axillo-breast approach (BABA) to endoscopic thyroidectomy and applied it to the da Vinci robotic surgical system in 2008. Herein, we have analyzed the immediate postoperative outcomes and 1-year follow-up results of robotic BABA total thyroidectomy with central node dissection (CND). In 2008 and 2009, 109 patients with PTC underwent robotic BABA total thyroidectomy with CND. Clinicopathologic characteristics, short- and long-term complications, and postoperative thyroglobulin (Tg) level were obtained prospectively and analyzed. The mean age was 39 ± 10 years and the male to female ratio was 1:5.8. The mean operation time was 206 ± 36 minutes. Transient recurrent laryngeal nerve (RLN) palsy occurred in 17 cases (16%) and transient hypocalcemia in 21 cases (19%). The median follow-up was 12 months. There were 1 and 2 cases of permanent RLN palsy and permanent hypoparathyroidism, respectively. Postoperative radioactive iodine ablation was performed on 54 patients (50%). Their mean stimulated Tg level was 1.84 ± 6.35 ng/mL and 76% had stimulated Tg levels <1.0 ng/mL. Robotic BABA total thyroidectomy with CND yields good postoperative outcomes. Given the excellent cosmetic outcomes, this technique may be a suitable operative alternative for low-risk patients with PTC.