Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2022 Jul 7;12(1):11531. doi: 10.1038/s41598-022-15908-x.
Locoregional recurrent thyroid cancer is commonly treated with re-do operation. This study aimed to investigate the feasibility of using robotic system for re-do operation in locoregional recurrent thyroid cancer. Sixty-five patients who underwent re-do robotic operation using trans-axillary approach for locoregional recurrent thyroid cancer from October 2007 to April 2021 at Yonsei University Hospital were analyzed. Completion total thyroidectomy (CTT) was performed in 26 cases, CTT and modified radical neck node dissection (mRND) in 16, and mRND in 23. Most of the re-do robotic operations were performed at site of previous incision. All patients were diagnosed with papillary thyroid carcinoma (PTC). CTT with central compartment neck dissection (CCND) took 117.6 ± 26.3 min, CTT with mRND 255.6 ± 38.6 min, and mRND, 211.7 ± 52.9 min. Transient hypocalcemia occurred in 17 (26.2%) patients and permanent hypocalcemia occurred in 3 (4.6%). There was one case of recurrent laryngeal nerve(RLN) injury. One patient was diagnosed with structural recurrence after re-do robotic operation. Median follow-up duration was 50.7 ± 37.1 months. Re-do robotic operation can be an alternative for patients who are diagnosed with locoregional recurrent thyroid cancer after thyroidectomy, with no increase in morbidity, similar oncologic outcomes, and superior cosmetic satisfaction.
局部区域性复发性甲状腺癌通常采用再次手术治疗。本研究旨在探讨机器人系统在局部区域性复发性甲状腺癌再次手术中的应用可行性。分析了 2007 年 10 月至 2021 年 4 月期间，在延世大学医院，采用经腋入路行再次机器人手术治疗局部区域性复发性甲状腺癌的 65 例患者。26 例行完全甲状腺切除术（CTT），16 例行 CTT 和改良根治性颈淋巴结清扫术（mRND），23 例行 mRND。大多数再次机器人手术均在原切口部位进行。所有患者均诊断为甲状腺乳头状癌（PTC）。行 CTT 加中央区颈淋巴结清扫术（CCND）用时 117.6±26.3min，行 CTT 加 mRND 用时 255.6±38.6min，行 mRND 用时 211.7±52.9min。术后 17 例（26.2%）患者出现短暂性低钙血症，3 例（4.6%）患者出现永久性低钙血症。1 例患者出现喉返神经（RLN）损伤。1 例患者在再次机器人手术后诊断为结构性复发。中位随访时间为 50.7±37.1 个月。对于甲状腺切除术后诊断为局部区域性复发性甲状腺癌的患者，再次机器人手术是一种替代治疗方法，其发病率无增加，肿瘤学结局相似，美容满意度更高。
