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- Title
Transaxillary robotic modified radical neck dissection: a 5-year assessment of operative and oncologic outcomes.
- Authors
Kim, Min; Lee, Jandee; Lee, Seul; Choi, Jung; Kim, Tae; Ban, Eun; Lee, Cho; Kang, Sang-Wook; Jeong, Jong; Nam, Kee-Hyun; Jo, Young; Chung, Woong; Kim, Min Jhi; Lee, Seul Gi; Choi, Jung Bum; Kim, Tae Hyung; Ban, Eun Jeong; Lee, Cho Rok; Jeong, Jong Ju; Jo, Young Suk
- Abstract
<bold>Background: </bold>Robotic modified radical neck dissection (MRND) using a gasless transaxillary approach has been reported to be a safe and meticulous technique in patients with papillary thyroid carcinoma (PTC) and lateral neck node metastasis (N1b). Few studies, however, have attempted to assess the long-term oncologic outcomes of robotic MRND in these patients. This study aimed to compare perioperative and 5-year oncologic outcomes of robotic MRND with conventional open procedures in patients with N1b PTC.<bold>Methods: </bold>Between September 2007 and February 2010, 193 patients with N1b PTC underwent total thyroidectomy and MRND by a single surgeon. Of these, 42 (21.8 %) underwent robotic procedures and 151 (78.2 %) underwent conventional open procedures. All patients received 3.7- to 5.5-GBq radioactive iodine (RAI) ablation, post-therapy whole-body scans (TxWBSs), and diagnostic WBS (DxWBSs) during follow-up. An exact 1:3 matching for age and stage was performed to minimize selection bias, and perioperative and 5-year oncologic outcomes were compared in the matched groups.<bold>Results: </bold>The mean follow-up period was 66.0 months (range 60-90 months). Number of retrieved cervical lymph nodes (LNs) (p = .102) and postoperative ablation success rates (p = .864) were similar between the two groups. TSH-suppressed serum Tg concentrations after 5 years (0.7 ± 1.5 vs. 2.4 ± 14.1 ng/ml; p = .471) and recurrence rates in the robotic and open groups (1/41 [2.4 %] vs. 3/102 [2.9 %]; p = .864) were similar for the 5-year follow-up period. Four patients experienced recurrence: Three exhibited regional lymph node metastasis, and one showed bilateral lung metastases.<bold>Conclusion: </bold>The perioperative and 5-year oncologic outcomes were similar after robotic and conventional open MRND. Large, prospective randomized controlled trials with long-term follow-up data are needed to validate these results.
- Subjects
NECK dissection; SURGICAL robots; PATIENT safety; THYROIDECTOMY; POSTOPERATIVE care; CANCER relapse; COMPARATIVE studies; DIAGNOSTIC imaging; LENGTH of stay in hospitals; LONGITUDINAL method; LYMPH nodes; RESEARCH methodology; MEDICAL cooperation; METASTASIS; NECK surgery; RESEARCH; THYROID gland tumors; EVALUATION research; TREATMENT effectiveness; PAPILLARY carcinoma
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 4, p1599
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-016-5146-9