Technical and Oncologic Safety of Robotic Thyroid Surgery

Abstract

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