Kwak Hee Yong, Kim Hoon Yub, Lee Hye Yoon, Jung Seung Pil, Woo Sang Uk, Son Gil Soo, Lee Jae Bok, Bae Jeoung Won
Department of Surgery, Korea University College of Medicine, Seoul, Korea.
J Surg Oncol. 2015 Feb;111(2):141-5. doi: 10.1002/jso.23674. Epub 2014 Jun 5.
The aim of the present study was to compare the surgical outcomes of robotic thyroidectomy using the bilateral axillo-breast approach (BABA) with open conventional thyroidectomy.
Database of patients who underwent thyroidectomy with cervical lymph node dissection after diagnosed as papillary thyroid carcinoma between July 2008 and February 2013 were examined. Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities of robot group and open group were investigated.
The dominant tumor size (P=0.974), body mass index (BMI) (P=0.426), and the mean number of metastatic lymph nodes in central compartment neck dissection (P=0.269) were comparable between the two groups. The mean number of retrieved central lymph nodes was higher in the open group than in the robot group (P=0.001). Postoperative complications were comparable: hypoparathyroidism in 2 weeks (P=0.296) and 3 months (P=0.446) after the surgery; vocal cord palsy in 2 weeks (P=0.363) and 3 months (P=0.312); hematoma (P=0.162); and wound infection (P=0.421).
Robotic thyroidectomy using BABA may be a technically feasible and safe procedure comparable to conventional open surgery especially in node-negative patients.
本研究旨在比较采用双侧腋窝-乳晕入路(BABA)的机器人甲状腺切除术与开放性传统甲状腺切除术的手术效果。
检查2008年7月至2013年2月期间被诊断为甲状腺乳头状癌后接受甲状腺切除术及颈部淋巴结清扫术的患者数据库。调查机器人手术组和开放手术组的临床病理特征、手术效果及术后并发症。
两组患者的主要肿瘤大小(P=0.974)、体重指数(BMI)(P=0.426)以及中央区颈部淋巴结清扫术中转移淋巴结的平均数量(P=0.269)相当。开放手术组获取的中央区淋巴结平均数量高于机器人手术组(P=0.001)。术后并发症相当:术后2周(P=0.296)和3个月(P=0.446)时的甲状旁腺功能减退;术后2周(P=0.363)和3个月(P=0.312)时的声带麻痹;血肿(P=0.162);以及伤口感染(P=0.421)。
采用BABA的机器人甲状腺切除术可能是一种技术上可行且安全的手术,与传统开放手术相当,尤其是对于无淋巴结转移的患者。