Objectives/hypothesis: The aim of this study was to investigate the surgical completeness of robotic total thyroidectomy compared with conventional open thyroidectomy.
Study design: Retrospective, case-control study.
Methods: We studied 245 patients with papillary thyroid carcinoma who underwent total thyroidectomy and postoperative radioactive iodine (RAI) ablation. Of these, 62 patients underwent robotic thyroidectomy by a gasless unilateral axillo-breast (GUAB) or axillary (GUA) approach, and 183 underwent conventional open thyroidectomy. We analyzed serum TSH-stimulated thyroglobulin (Tg) and RAI uptake at the time of RAI remnant ablation to compare surgical completeness in the two groups.
Results: Tumor characteristics and complications did not differ between the two groups except TNM stage. The mean TSH-stimulated Tg at the first RAI ablation was significantly higher in the robotic group (10.20 ± 9.98 ng/ml) than in the open group (3.85 ± 6.79 ng/ml) (P <0.001). In subgroup analysis of the robotic group by the period in which operations took place, TSH-stimulated Tg was significantly higher than in the open group in the first (13.28 ± 11.91 ng/ml) and second (10.45 ± 9.30 ng/ml) periods, but there was no significant difference in the third period (6.00 ± 6.26 ng/ml, P = 0.141). The RAI uptake rate at the first RAI ablation did not differ between the two groups, and TSH-stimulated Tg after RAI ablation was similar.
Conclusion: The surgical completeness of robotic total thyroidectomy by a GUAB/GUB approach is comparable to that of open thyroidectomy, if performed by experienced robotic thyroid surgeons in properly selected patients.
Level of evidence: 3b. Laryngoscope, 124:1042-1047, 2014.
Keywords: Robotic thyroidectomy; endoscopic thyroidectomy; gasless unilateral axillary approach; gasless unilateral axillo-breast approach; papillary thyroid carcinoma.
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.