Surgical safety and oncological completeness of robotic thyroidectomy for thyroid carcinoma larger than 2 cm

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Abstract
Background The safety of robotic thyroidectomy (RT) for small-sized thyroid carcinomas has been well established. The surgical outcomes of bilateral axillo-breast approach RT for thyroid carcinomas larger than 2 cm were evaluated and compared with those of open thyroidectomy (OT). Methods The medical records of patients who underwent total thyroidectomy or hemithyroidectomy followed by completion thyroidectomy for differentiated thyroid carcinomas measuring 2–4 cm were retrospectively reviewed. Results The study included 86 patients who underwent RT (n = 21) or OT (n = 65) with mean ages of 30.8 and 51.6 years, respectively. The mean tumor size was 2.8 cm in both groups. There were no significant differences between the RT and OT groups in vocal cord palsy rate (transient, 19.0 vs. 9.2 %; permanent, 0 vs. 1.5 %), postoperative hypoparathyroidism rate (transient, 19.0 vs. 33.8 %; permanent, 4.8 vs. 1.5 %), and the number of retrieved central lymph nodes in papillary thyroid carcinoma patients (6.4 ± 3.5 vs. 6.1 ± 3.9, respectively). The proportion of the patients with serum stimulated thyroglobulin level of p = 0.920). There were three patients (1 RT and 2 OT) who had a biochemical incomplete response, and there was no case of anatomical recurrence or mortality during the median follow-up period of 40.2 months. Conclusion RT is a safe and oncologically sound treatment option for differentiated thyroid carcinomas measuring 2–4 cm in a selected group of patients. The role of RT should be evaluated in correlation with technological advances and increased experience.
Funding Information
  • Korean Foundation for Cancer Research (CB-2011-03-01)
  • Ministry of Science, ICT and Future Planning (2015R1C1A1A01055464)

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