Chai Young Jun, Song Junho, Kang Jiyoung, Woo Jung-Woo, Song Ra-Yeong, Kwon Hyungju, Kim Su-Jin, Choi June Young, Lee Kyu Eun
Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Korea.
Ann Surg Treat Res. 2016 May;90(5):239-45. doi: 10.4174/astr.2016.90.5.239. Epub 2016 May 2.
Postoperative pain for robotic thyroid surgeries including bilateral axillo-breast approach (BABA) has not been well studied. In this study, we have developed a self-reporting application (SRA) for iPad and prospectively collected pain scores from open thyroidectomy (OT) and BABA robotic thyroidectomy (RT) patients.
Female patients who underwent total thyroidectomy for papillary thyroid carcinoma were included. Patients recorded pain scores for throat, anterior neck, posterior neck, chest, and back on postoperative days 1, 2, and 3. Once discharged, on postoperative day 14, a survey was also conducted on satisfaction of SRA and cosmesis.
A total of 54 patients were enrolled (27 BABA RT and 27 OT). There were no significant differences between the 2 groups in clinicopathological characteristics and postoperative complication rates. Postoperative pain scores at days 1, 2, 3, and 14 were not significantly different between the groups for throat, anterior neck, posterior neck, or back. Postoperative analgesic requirements were similar between the 2 groups. Wound satisfaction scores were significantly higher in the BABA RT group (BABA RT 7.4 vs. OT 5.7; P = 0.016). Satisfaction scores for the usefulness of SRA were above 7.2 for all four questionnaire items on the 10-point scale.
Postoperative pain for BABA RT is equivalent to OT but offers greater cosmetic satisfaction for patients. A mobile device application such as SRA may facilitate proper assessment and management of pain in postoperative patients.
包括双侧腋窝-乳房入路（BABA）在内的机器人甲状腺手术的术后疼痛尚未得到充分研究。在本研究中，我们开发了一款适用于iPad的自我报告应用程序（SRA），并前瞻性地收集了开放性甲状腺切除术（OT）和BABA机器人甲状腺切除术（RT）患者的疼痛评分。
纳入因乳头状甲状腺癌接受全甲状腺切除术的女性患者。患者在术后第1、2和3天记录喉咙、颈前、颈后、胸部和背部的疼痛评分。出院后，在术后第14天，还对SRA的满意度和美容效果进行了调查。
共纳入54例患者（27例BABA RT和27例OT）。两组在临床病理特征和术后并发症发生率方面无显著差异。两组在术后第1、2、3和14天喉咙、颈前、颈后或背部的术后疼痛评分无显著差异。两组术后镇痛需求相似。BABA RT组的伤口满意度评分显著更高（BABA RT为7.4 vs. OT为5.7；P = 0.016）。在10分制的所有四个问卷项目中，SRA有用性的满意度评分均高于7.2。
BABA RT的术后疼痛与OT相当，但为患者提供了更高的美容满意度。诸如SRA之类的移动设备应用程序可能有助于对术后患者的疼痛进行适当评估和管理。
