Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Surg Endosc. 2011 Mar;25(3):906-12. doi: 10.1007/s00464-010-1296-3. Epub 2010 Aug 24.
Robotic thyroidectomy and lymph node dissection is rapidly emerging as an alternative to conventional endoscopic thyroidectomy for thyroid carcinoma. Robot techniques incorporate the advantages of endoscopic procedures while overcoming some of the problems. We present the largest multi-institution clinical study of robotic thyroidectomy for thyroid carcinomas. The robotic thyroidectomy involved gasless transaxillary approach using the da Vinci surgical robot system.
We reviewed a database of 1,043 consecutive patients with low-risk differentiated thyroid carcinoma who underwent robotic thyroidectomy between October 2007 and August 2009. Operations were performed by five surgeons at four academic centers. We analyzed perioperative, clinical, and pathological data.
The study involved 71 men and 972 women, with a mean age of 39 (range, 15-70) years. All operations were performed successfully without any need for conventional open or endoscopic conversion. There were 366 total thyroidectomies and 677 subtotal thyroidectomies with cervical lymph node dissection. The mean overall operation time and console time were 132.4 and 63.9 min, respectively. There were ten (1%) major postoperative morbidities. The mean tumor size was 0.8 (range, 0.1-6.0) cm, and the mean number of retrieved central lymph nodes was 5.1 ± 3.8 (range, 0-26). The mean postoperative hospital stay was 2.9 (range, 1-8) days.
Robotic thyroidectomy using gasless transaxillary method was feasible, safe, and provided good outcomes for patients with differentiated thyroid carcinoma. Robotic technology overcame some technical limitations associated with conventional endoscopy.
机器人甲状腺切除术和淋巴结清扫术作为甲状腺癌的一种替代传统内镜甲状腺切除术的方法迅速兴起。机器人技术结合了内镜手术的优势，同时克服了一些问题。我们报告了最大的多机构临床研究机器人甲状腺切除术治疗甲状腺癌。机器人甲状腺切除术采用达芬奇手术机器人系统进行无气经腋窝入路。
我们回顾了 2007 年 10 月至 2009 年 8 月期间 1043 例低危分化型甲状腺癌患者接受机器人甲状腺切除术的数据库。手术由 5 位外科医生在 4 个学术中心进行。我们分析了围手术期、临床和病理数据。
研究共涉及 71 名男性和 972 名女性，平均年龄为 39 岁（范围 15-70 岁）。所有手术均成功完成，无需常规开放或内镜转换。共进行了 366 例全甲状腺切除术和 677 例次全甲状腺切除术及颈淋巴结清扫术。总手术时间和控制台时间的平均值分别为 132.4 分钟和 63.9 分钟。有 10 例（1%）严重术后并发症。肿瘤平均大小为 0.8cm（范围 0.1-6.0cm），平均检出中央淋巴结 5.1±3.8 个（范围 0-26 个）。平均术后住院时间为 2.9 天（范围 1-8 天）。
采用无气经腋窝入路的机器人甲状腺切除术是可行的、安全的，为分化型甲状腺癌患者提供了良好的结果。机器人技术克服了传统内镜相关的一些技术限制。
