Lee Hee Seung, Chai Young Jun, Kim Su-Jin, Choi June Young, Lee Kyu Eun
Department of Surgery, Dongguk University Gyeongju Hospital, Dongguk University College of Medicine, Gyeongju, Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.; Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
Ann Surg Treat Res. 2016 Jul;91(1):1-7. doi: 10.4174/astr.2016.91.1.1. Epub 2016 Jun 30.
Obesity is associated with a number of medical comorbidities and is considered a risk factor for surgical complications. The purpose of this study was to analyze the influence of body habitus including obesity on the surgical outcomes of the Bilateral axillo-breast approach (BABA) robotic thyroidectomy (RoT) in papillary thyroid carcinoma (PTC) patients.
The medical records of 456 PTC patients who underwent BABA RoT between January 2011 and December 2012 were reviewed, and 310 women PTC patients who had undergone BABA robotic total thyroidectomy with central lymph node dissection were examined. Body habitus were evaluated by measuring body mass index (BMI), body surface area, and neck circumference. We divided the patients into BMI < 25 kg/m(2) and BMI ≥ 25 kg/m(2) groups. Clinicopathological data, surgical outcomes, and postoperative complications were evaluated.
Clinicopathological characteristics did not differ between the 2 BMI groups. The creation of working space time (P = 0.210) and other surgical outcomes showed no significant differences between the groups. There were no statistically significant differences between body habitus indexes and postoperative length of hospital stay, number of retrieved central lymph nodes, postoperative thyroglobulin levels, occurrence of hypoparathyoidism, recurrent laryngeal nerve injury and wound complication.
Patient with large body habitus undergoing BABA RoT were not at an increased risk of surgical complications and showed good surgical outcomes. BABA RoT may be a good alternative operative method for PTC patients for whom cosmetic outcome is an important consideration.
肥胖与多种医学合并症相关，被认为是手术并发症的一个危险因素。本研究的目的是分析包括肥胖在内的身体形态对双侧腋窝-乳房入路（BABA）机器人甲状腺切除术（RoT）治疗乳头状甲状腺癌（PTC）患者手术结局的影响。
回顾了2011年1月至2012年12月期间接受BABA RoT的456例PTC患者的病历，并检查了310例接受BABA机器人全甲状腺切除术并进行中央淋巴结清扫的女性PTC患者。通过测量体重指数（BMI）、体表面积和颈围来评估身体形态。我们将患者分为BMI < 25 kg/m²和BMI≥25 kg/m²两组。评估临床病理数据、手术结局和术后并发症。
两个BMI组之间的临床病理特征没有差异。建立工作空间时间（P = 0.210）和其他手术结局在两组之间没有显著差异。身体形态指标与术后住院时间、中央淋巴结清扫数量、术后甲状腺球蛋白水平、甲状旁腺功能减退的发生、喉返神经损伤和伤口并发症之间没有统计学上的显著差异。
接受BABA RoT的身体形态较大的患者手术并发症风险没有增加，且手术结局良好。对于美容效果是重要考虑因素的PTC患者，BABA RoT可能是一种很好的替代手术方法。
