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Multicenter study of robotic thyroidectomy: short-term postoperative outcomes and surgeon ergonomic considerations

Authors
 Jandee Lee  ;  Sang Wook Kang  ;  Jeong Ju Jung  ;  Un Jung Choi  ;  Jong Ho Yun  ;  Kee Hyun Nam  ;  Euy-Young Soh  ;  Woong Youn Chung 
Citation
 ANNALS OF SURGICAL ONCOLOGY, Vol.18(9) : 2538-2547, 2011 
Journal Title
ANNALS OF SURGICAL ONCOLOGY
ISSN
 1068-9265 
Issue Date
2011
MeSH
Adolescent ; Adult ; Aged ; Carcinoma, Papillary/complications ; Carcinoma, Papillary/pathology ; Carcinoma, Papillary/surgery* ; Female ; Follow-Up Studies ; Humans ; Hypocalcemia/diagnosis ; Hypocalcemia/etiology* ; Hypocalcemia/surgery ; Male ; Middle Aged ; Practice Patterns, Physicians'* ; Prognosis ; Recurrent Laryngeal Nerve Injuries/diagnosis ; Recurrent Laryngeal Nerve Injuries/etiology* ; Recurrent Laryngeal Nerve Injuries/surgery ; Robotics* ; Survival Rate ; Thyroid Neoplasms/complications ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery* ; Thyroidectomy* ; Young Adult
Keywords
Thyroid Cancer ; Papillary Thyroid Carcinoma ; Endoscopic Thyroidectomy ; Robotic Thyroidectomy ; Open Thyroidectomy
Abstract
BACKGROUND: Robotic thyroidectomy (RT) has recently emerged as a viable approach to thyroid surgery, resulting in better functional and cosmetic outcomes than afforded by open thyroidectomy (OT). The present multicenter study assessed the perioperative outcomes of RT and compared physician perspectives on the musculoskeletal ergonomic parameters associated with OT, endoscopic thyroidectomy (ET), and RT.

MATERIALS AND METHODS: We reviewed the medical records of 2014 consecutive patients who underwent RT, conducted by 7 surgeons, at 4 centers between October 2007 and June 2010. Patient characteristics, perioperative clinical results, complications, and pathologic outcomes were analyzed. Moreover, surgeons were surveyed to gather data on musculoskeletal discomfort experienced during OT, ET, and RT.

RESULTS: Of the 2014 patients, 740 underwent total and 1274 subtotal thyroidectomy. Mean tumor diameter was 0.8 cm, and the mean number of retrieved central lymph nodes was 4.5 ± 3.9 (range 0-28). The rates of permanent recurrent laryngeal nerve injury and permanent hypocalcemia were 0.4 and 0.05%, respectively. Neck and/or back pain after OT, ET, and RT was experienced by 100, 85.7, and 28.6% of surgeons, respectively. When surgeons ranked the operative approaches in decreasing order of associated pain, 57.1% indicated ET > OT > RT, 28.6% selected OT > ET > RT, and 14.3% responded ET > RT > OT.

CONCLUSION: RT is a feasible and safe procedure that may facilitate radical cervical lymph node dissection. Moreover, for surgeons, the RT resulted in less musculoskeletal discomfort than did OT or ET. A larger prospective study, with a longer follow-up, is needed to determine whether RT offers real benefits for both patients and surgeons.
Full Text
http://link.springer.com/article/10.1245%2Fs10434-011-1628-0
DOI
10.1245/s10434-011-1628-0
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
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/22282913/93634
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