Nisar Zaidi1, Despoina Daskalaki2, Pablo Quadri2, Alexis Okoh3, Pier Cristoforo Giulianotti2, Eren Berber3. 1. Department of Surgery, Essentia Health - Duluth Clinic, Duluth, MN, USA. 2. Center for Endocrine Surgery, Cleveland Clinic, Cleveland, OH, USA. 3. Division of General, Minimally Invasive and Robotic Surgery, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
BACKGROUND: Few studies exist regarding the state of robotic transaxillary thyroidectomy (RT) and its outcomes at high-volume institutions. METHODS: Eighty-nine patients underwent RT between January 2009 and September 2015 at two tertiary centers. Data were collected from prospectively-maintained IRB-approved databases. Patient demographic and clinical data, and trends were evaluated. RESULTS: Indications for RT included biopsy-proven or suspicion for malignancy in 20.2%, atypical cells or follicular neoplasm in 27.7%, multinodular goiter in 26.6%, thyrotoxicosis in 8.5%, need for completion thyroidectomy in 5.3%, and non-diagnostic FNA in 3.2%. 56% underwent total thyroidectomy and 44% lobectomy. Operative time (OT) was 153.5 minutes for lobectomies and 192.6 minutes for total thyroidectomy. The complication rate was 11.7%: temporary RLN neuropraxia in 2 patients, permanent hypoparathyroidism in 1 patient, temporary hypoparathyroidism in 6 patients, flap seroma in 1 patient, and flap hematoma in 1 patient. Pathology showed malignancy in 43 patients. At a mean follow-up of 31.9 months, there were no recurrences. Since 2013, the number of RTs performed has risen. The number of out-of-state patients increased from 18% to 37% after 2011. CONCLUSIONS: RT was performed without compromising outcomes in selected patients. There remains interest among patients seeking this procedure in expert centers.
BACKGROUND: Few studies exist regarding the state of robotic transaxillary thyroidectomy (RT) and its outcomes at high-volume institutions. METHODS: Eighty-nine patients underwent RT between January 2009 and September 2015 at two tertiary centers. Data were collected from prospectively-maintained IRB-approved databases. Patient demographic and clinical data, and trends were evaluated. RESULTS: Indications for RT included biopsy-proven or suspicion for malignancy in 20.2%, atypical cells or follicular neoplasm in 27.7%, multinodular goiter in 26.6%, thyrotoxicosis in 8.5%, need for completion thyroidectomy in 5.3%, and non-diagnostic FNA in 3.2%. 56% underwent total thyroidectomy and 44% lobectomy. Operative time (OT) was 153.5 minutes for lobectomies and 192.6 minutes for total thyroidectomy. The complication rate was 11.7%: temporary RLN neuropraxia in 2 patients, permanent hypoparathyroidism in 1 patient, temporary hypoparathyroidism in 6 patients, flap seroma in 1 patient, and flap hematoma in 1 patient. Pathology showed malignancy in 43 patients. At a mean follow-up of 31.9 months, there were no recurrences. Since 2013, the number of RTs performed has risen. The number of out-of-state patients increased from 18% to 37% after 2011. CONCLUSIONS: RT was performed without compromising outcomes in selected patients. There remains interest among patients seeking this procedure in expert centers.
Authors: Andrew M Hinson; Emad Kandil; Stephanie O'Brien; Horace J Spencer; Donald L Bodenner; Samuel F Hohmann; Brendan C Stack Journal: Thyroid Date: 2015-07-14 Impact factor: 6.568
Authors: Christine S Landry; Elizabeth G Grubbs; G Stephen Morris; Nadine S Turner; F Christopher Holsinger; Jeffrey E Lee; Nancy D Perrier Journal: Surgery Date: 2010-10-14 Impact factor: 3.982