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Transaxillary robotic modified radical neck dissection: a 5-year assessment of operative and oncologic outcomes

 Min Jhi Kim  ;  Jandee Lee  ;  Seul Gi Lee  ;  Jung Bum Choi  ;  Tae Hyung Kim  ;  Eun Jeong Ban  ;  Cho Rok Lee  ;  Sang-Wook Kang  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Young Suk Jo  ;  Woong Youn Chung 
 Surgical Endoscopy , Vol.31(4) : 1599-1606, 2017 
Journal Title
 Surgical Endoscopy  
Issue Date
Adult ; Carcinoma, Papillary/mortality ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery* ; Female ; Follow-Up Studies ; Humans ; Length of Stay/statistics & numerical data ; Lymph Nodes/pathology* ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Neck Dissection*/methods ; Neoplasm Recurrence, Local/pathology ; Neoplasm Recurrence, Local/surgery* ; Prospective Studies ; Robotic Surgical Procedures* ; Thyroid Neoplasms/mortality ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery* ; Thyroidectomy*/methods ; Treatment Outcome ; Whole Body Imaging
Lateral neck node metastasis ; Modified radical neck dissection ; Oncologic outcome ; Papillary thyroid cancer ; Robotic surgery
BACKGROUND: Robotic modified radical neck dissection (MRND) using a gasless transaxillary approach has been reported to be a safe and meticulous technique in patients with papillary thyroid carcinoma (PTC) and lateral neck node metastasis (N1b). Few studies, however, have attempted to assess the long-term oncologic outcomes of robotic MRND in these patients. This study aimed to compare perioperative and 5-year oncologic outcomes of robotic MRND with conventional open procedures in patients with N1b PTC. METHODS: Between September 2007 and February 2010, 193 patients with N1b PTC underwent total thyroidectomy and MRND by a single surgeon. Of these, 42 (21.8 %) underwent robotic procedures and 151 (78.2 %) underwent conventional open procedures. All patients received 3.7- to 5.5-GBq radioactive iodine (RAI) ablation, post-therapy whole-body scans (TxWBSs), and diagnostic WBS (DxWBSs) during follow-up. An exact 1:3 matching for age and stage was performed to minimize selection bias, and perioperative and 5-year oncologic outcomes were compared in the matched groups. RESULTS: The mean follow-up period was 66.0 months (range 60-90 months). Number of retrieved cervical lymph nodes (LNs) (p = .102) and postoperative ablation success rates (p = .864) were similar between the two groups. TSH-suppressed serum Tg concentrations after 5 years (0.7 ± 1.5 vs. 2.4 ± 14.1 ng/ml; p = .471) and recurrence rates in the robotic and open groups (1/41 [2.4 %] vs. 3/102 [2.9 %]; p = .864) were similar for the 5-year follow-up period. Four patients experienced recurrence: Three exhibited regional lymph node metastasis, and one showed bilateral lung metastases. CONCLUSION: The perioperative and 5-year oncologic outcomes were similar after robotic and conventional open MRND. Large, prospective randomized controlled trials with long-term follow-up data are needed to validate these results.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jhi(김민지)
Kim, Tae Hyung(김태형)
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Ban, Eun Jeong(반은정)
Lee, Seul Gi(이슬기) ORCID logo https://orcid.org/0000-0003-3233-7823
Lee, Jan Dee(이잔디) ORCID logo https://orcid.org/0000-0003-4090-0049
Lee, Cho Rok(이초록) ORCID logo https://orcid.org/0000-0001-7848-3709
Chung, Woung Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
Jo, Young Suk(조영석) ORCID logo https://orcid.org/0000-0001-9926-8389
Choi, Jung Bum(최정범)
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