Kim Dahee, Sim Nam Suk, Kim Dachan, Choi Eun Chang, Chang Jae Won, Koh Yoon Woo
Department of Otorhinolaryngology, Severance Hospital, Yonsei University Health System, Yonsei University College of Medicine, Seoul 03722, Korea.
Department of Otorhinolaryngology, Chungnam National University, Daejeon 34134, Korea.
J Clin Med. 2022 Jun 9;11(12):3320. doi: 10.3390/jcm11123320.
Pediatric thyroid cancer more frequently develops cervical node metastasis than adult thyroid cancer, even in differentiated thyroid carcinoma (DTC). Thus, cervical neck dissection often needs to be performed simultaneously with thyroidectomy in pediatric patients. Herein, we describe our experience with robot-assisted total thyroidectomy with/without robot-assisted neck dissection in pediatric patients compared with the conventional operated group. A total of 30 pediatric patients who underwent thyroidectomy for DTC between July 2011 and December 2019 were retrospectively reviewed. Among them, 22 underwent robot-assisted operation, whereas 8 underwent conventional operation. There was no statistical difference in the mean operation times, blood loss, drainage amounts, and hospital stay length between the robot-assisted and conventional operation groups; however, the operation time was less in the retroauricular approach subgroup (robot-assisted operation group) with better satisfaction on cosmesis. No postoperative complications, such as seromas, hemorrhages, or hematomas were observed. Our experience suggested that robot-assisted thyroidectomy with or without neck dissection through the retroauricular approach is a feasible and safe alternative treatment, producing outstanding esthetic results compared to the conventional approach, especially in pediatric patients with DTC.
与成人甲状腺癌相比，小儿甲状腺癌更易发生颈部淋巴结转移，即使是分化型甲状腺癌（DTC）也是如此。因此，小儿患者常需在甲状腺切除术的同时进行颈部淋巴结清扫术。在此，我们描述了小儿患者机器人辅助全甲状腺切除术伴或不伴机器人辅助颈部淋巴结清扫术的经验，并与传统手术组进行了比较。回顾性分析了2011年7月至2019年12月期间因DTC接受甲状腺切除术的30例小儿患者。其中，22例行机器人辅助手术，8例行传统手术。机器人辅助手术组与传统手术组在平均手术时间、失血量、引流量和住院时间方面无统计学差异；然而，耳后入路亚组（机器人辅助手术组）的手术时间更短，美容满意度更高。未观察到术后并发症，如血清肿、出血或血肿。我们的经验表明，采用或不采用耳后入路进行机器人辅助颈部淋巴结清扫术的甲状腺切除术是一种可行且安全的替代治疗方法，与传统方法相比，具有出色的美容效果，尤其适用于患有DTC的小儿患者。
