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Factors contributing to surgical outcomes of transaxillary robotic thyroidectomy for papillary thyroid carcinoma

Authors
 Haiyoung Son  ;  Seulkee Park  ;  Cho Rok Lee  ;  Sohee Lee  ;  Jung Woo Kim  ;  Sang-Wook Kang  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Woong Youn Chung  ;  Cheong Soo Park 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.28(11) : 3134-3142, 2014 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2014
MeSH
Adolescent ; Adult ; Blood Loss, Surgical/statistics & numerical data ; Body Mass Index ; Carcinoma/epidemiology ; Carcinoma/surgery* ; Carcinoma, Papillary ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Operative Time ; Organ Size ; Postoperative Complications/epidemiology ; Retrospective Studies ; Robotics/methods* ; Sex Factors ; Thyroid Gland/pathology ; Thyroid Neoplasms/epidemiology ; Thyroid Neoplasms/surgery* ; Thyroidectomy/methods* ; Thyroiditis/epidemiology ; Treatment Outcome ; Young Adult
Keywords
Robotic thyroidectomy ; Surgical outcomes ; Contributing factors ; Inexperienced surgeon ; Patient selection
Abstract
INTRODUCTION: Transaxillary robotic thyroidectomy is considered a technically feasible and safe treatment option for patients with low-risk papillary thyroid carcinoma (PTC). The aim of the present study was to determine the factors that contribute to the perioperative surgical outcomes of robotic thyroidectomy and to suggest guidelines for patient selection to be used by surgeons inexperienced in the technique. METHOD: We reviewed the records of 275 patients with PTC who underwent robotic total thyroidectomy using a gasless, transaxillary single-incision approach at Yonsei University Health System, South Korea, between January 2011 and May 2012. The association between surgical outcomes and clinicopathologic factors was assessed using linear and logistic regression analysis. RESULTS: The contributing factors for surgical outcomes of robotic thyroidectomy were categorized as patient factors, including gender and body mass index (BMI), and thyroid-specific factors, including thyroid gland size, coexistent thyroiditis, tumor size, and serum anti-thyroglobulin antibody and anti-microsomal antibody titers. Of these, male gender, a large thyroid gland, and thyroiditis significantly increased the total operation time. Male gender, thyroiditis, and overweight BMI increased the working space time, and a large thyroid gland and overweight BMI affected the console time. A large thyroid gland and histological thyroiditis were associated with increased intraoperative blood loss. There was no association between postoperative complications and clinicopathologic parameters. CONCLUSION: Male gender, overweight BMI, a large thyroid gland, and coexistent thyroiditis adversely affected the surgical outcome of robotic thyroidectomy. Surgeons inexperienced in the technique should avoid or carefully approach individuals with these factors.
Full Text
http://link.springer.com/article/10.1007/s00464-014-3567-x
DOI
10.1007/s00464-014-3567-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Sang Wook(강상욱) ORCID logo https://orcid.org/0000-0001-5355-833X
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138639
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