Ryu Chang Hwan, Seok Jungirl, Jung Yuh-Seog, Ryu Junsun
Department of Otorhinolaryngology-Head and Neck Surgery, National Cancer Center, Goyang, Republic of Korea.
Gland Surg. 2020 Oct;9(5):1267-1277. doi: 10.21037/gs-20-450.
Robot-assisted transaxillary approaches to thyroidectomy have been well described. They have an advantage over the breast approach in that a circumareolar incision is avoided. However, they require a single long axillary incision to accommodate all 3 robotic arms and provide adequate visualization of the area around the thyroid. The purpose of this study was to test the feasibility of the robot-assisted transaxillary gas-insufflation approach (TAGA) and to attempt reducing the size of the scar.
We evaluated 47 patients who underwent robot-assisted thyroid lobectomy via TAGA from July 2015 to Aug 2017. The following variables were studied: patients' demographics, operative time according to each operation step, volume of drainage, duration of hospitalization, and perioperative complications.
The mean age of all patients was 42.4±9.1 years. The mean total volume of drainage was 195.4±70.9 mL, and the duration of postoperative stay was 3.0±1.1 days. Two cases (4.3%) of transient vocal cord palsy and 2 cases (4.3%) of seroma were identified postoperatively. There was no post-operative cosmetic problem at the skin incisions made in the axilla.
Robot-assisted thyroid lobectomy via TAGA is technically feasible while achieving good cosmetic results. TAGA can be an alternative robot-assisted method for thyroidectomy.
机器人辅助经腋窝入路甲状腺切除术已有详细描述。与经乳房入路相比，其优势在于避免了乳晕周围切口。然而，它们需要一个单一的长腋窝切口来容纳所有3个机器人手臂，并提供甲状腺周围区域的充分视野。本研究的目的是测试机器人辅助经腋窝充气入路（TAGA）的可行性，并尝试减小瘢痕大小。
我们评估了2015年7月至2017年8月期间通过TAGA接受机器人辅助甲状腺叶切除术的47例患者。研究了以下变量：患者的人口统计学特征、每个手术步骤的手术时间、引流量、住院时间和围手术期并发症。
所有患者的平均年龄为42.4±9.1岁。平均总引流量为195.4±70.9 mL，术后住院时间为3.0±1.1天。术后发现2例（4.3%）出现短暂性声带麻痹，2例（4.3%）出现血清肿。腋窝皮肤切口处无术后美容问题。
通过TAGA进行机器人辅助甲状腺叶切除术在技术上是可行的，同时能取得良好的美容效果。TAGA可以成为一种替代的机器人辅助甲状腺切除方法。
