[Complications of Da Vinci robot thyroid surgery by bilateral axillo-breast approach]

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Apr 7;56(4):363-368. doi: 10.3760/cma.j.cn115330-20200824-00691.
[Article in Chinese]

Abstract

Objective: To evaluate the complications of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach. Methods: A retrospective analysis of complications was conducted on 1, 198 cases of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach of the 960 th Hospital of the People's Liberation Army from February 2014 to March 2020. There were 263 men and 935 women, age ranged from 9 to 68 years old, and included 288 benign lesions and 910 malignancies according to preoperative imaging examination, FNAC, and intraoperative frozen pathology. Results: Surgical complications occurred in 187 (15.61%) patients, including 10 cases of temporary larynx nerve injury (0.83%), 1 case of permanent larynx nerve injury (0.08%), and 152 cases of temporary hypoparathyroidism (12.69%), no permanent hypoparathyroidism, 1 case of hypoglossal injury (0.08%), 2 cases of facial nerve jaw branch damage (0.17%), 2 cases of trachea injury (0.17%), no esophagus damage, 5 cases of celiac leakage (0.42%), 3 cases of neck skin adhesion (0.25%), 2 cases of subdermal bleeding (0.17%), 2 cases of skin burns (0.17%), 5 cases of hematoma (0.42%), 1 case of cephalic artery rupture (0.08%), 1 case of jugular vein rupture (0.08%), no tumor cultivation, no arm plex nerve, accessory nerve or phrenic nerve damage. Conclusion: Da Vinci robot thyroid surgery by bilateral axillo-breast approach is safe, with less severe complications.

目的: 探讨双侧腋窝乳晕入路(bilateral axillo-breast approach,BABA)达芬奇机器人甲状腺手术并发症的特点。 方法: 回顾性分析解放军第九六〇医院2014年2月至2020年3月收治的1 198例经BABA行达芬奇机器人甲状腺手术患者的病例资料,其中男263例,女935例,年龄9~68岁。良性病变288例,恶性肿瘤910例。根据术前影像学检查、细针穿刺细胞学检查(FNAC)和术中冰冻病理选择术式,总结并发症的发生情况。 结果: 随访3个月~1年,187例(15.61%)患者出现并发症,手术并发症如下:暂时性喉返神经损伤10例(0.83%),永久性喉返神经损伤1例(0.08%),暂时性甲状旁腺功能减退152例(12.69%),无永久性甲状旁腺功能减退患者,舌下神经损伤1例(0.08%),面神经下颌缘支损伤2例(0.17%),气管损伤2例(0.17%),无食管损伤,乳糜漏5例(0.42%),颈部术区皮肤粘连错位3例(0.25%),皮下出血2例(0.17%),皮肤灼伤 2例(0.17%),血清肿5例(0.42%),颈总动脉破裂1例(0.08%),颈内静脉破裂1例(0.08%),无肿瘤种植,无臂丛神经、副神经和膈神经损伤。 结论: BABA达芬奇机器人甲状腺手术并发症少,是安全的术式。.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Axilla
  • Breast Neoplasms*
  • Carcinoma, Papillary* / surgery
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neck Dissection
  • Retrospective Studies
  • Robotic Surgical Procedures*
  • Robotics*
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy / adverse effects
  • Young Adult