Bu Ali, Daniah1; Aidan, Patrick2; Murad, Fadi1; Al-Qurayshi, Zaid1; Kang, Sang-Wook1; Kandil, Emad1
1 Department of surgery, Tulane University School of Medicine, New Orleans, LA, USA
2 American Hospital in Paris, Paris, France
Background: Many studies reported the safety of robot-assisted thyroidectomy, but most of these were performed in South Korea. Although there were several small series from the United States, most of them were for benign disease.The aim of our study is to report the safety and feasibility of robot-assisted thyroidectomy for thyroid cancer in the western population.
Methods: Retrospective review of patients who underwent robot-assisted thyroidectomy over 5 years for thyroid cancer, in two centers, one in France and one in USA. Those were compared to a control group who underwent open thyroidectomy. We analyzed demographic data, operative outcome and early oncologic outcome measures including; margins, biochemical and radiological evidence for recurrence.
Results: 108 robotic cases and 118 open were included. 28.70% underwent central lymph node dissection and 9.26% had lateral neck dissection.The transaxillary approach was performed in 93.5% and the remaining underwent retroauricular approach.In robotic cases, the mean age was45.58±10.58years and BMI was 26.09±6.47.The average nodule size was2.05±1.5cm.The mean operative time was 161.1±55.99 minutes with 3 patients required conversion to open.8(7.4%) patients developped complications including 1 hematoma, 3 seromas and 5 developed transient vocal cord paralysis.Two(1.92%) had focal positive margins, mean TG level was 0.16±0.4 and 2 (1.85%) developed recurrence 24 and 16 months following initial surgery.In comparison to open approach, the robotic approach had significantly longer operative time (p<001).There was no significant difference in the overall complication rate (p=0.15).
Conclusions: Robot-assisted thyroid surgery is a safe and feasible approach for managing selected group of patients with thyroid cancer in the western population, and is associated with sound oncologic outcome.