Excellence in Robotic Thyroid Surgery A Comparative Study of Robot-Assisted Versus Conventional Endoscopic Thyroidectomy in Papillary Thyroid Microcarcinoma Patients
Excellence in Robotic Thyroid Surgery A Comparative Study of Robot-Assisted Versus Conventional Endoscopic Thyroidectomy in Papillary Thyroid Microcarcinoma Patients
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DOI：
10.1097/sla.0b013e3182138b54
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发表时间：
2011-06-01
影响因子：
9
通讯作者：
Park, Cheong Soo
中科院分区：
文献类型：
--
作者：
Lee, Sohee;Ryu, Haeng Rang;Park, Cheong Soo
目的：通过比较机器人辅助和传统内镜甲状腺切除术治疗甲状腺乳头状微小癌（PTMC）patients.Background的手术结果，确认机器人甲状腺手术的优点：机器人辅助手术技术被广泛使用，并大大克服了传统内镜手术的局限性。此外，最近，机器人程序被引入到thyroidectomy field.Methods：从2001年11月至2009年7月，1150例PTMC患者进行了内镜下甲状腺切除术，使用无气体，经腋窝的方法。在这些患者中，580例接受了机器人手术（机器人组; RG），570例接受了传统内镜手术（传统内镜组; EG）。这2组进行了回顾性比较，在他们的临床病理特征，早期手术结果，和手术completenity.Results：甲状腺全切除术更频繁地在RG。虽然平均手术时间没有统计学差异，但RG中取出的中心淋巴结的平均数量大于EG。两组的平均肿瘤大小无显著差异，但RG显示更频繁的中央淋巴结转移和包膜浸润。RG中的肿瘤和淋巴结状态比EG中更先进。关于术后并发症，RG中一过性低钙血症更常见，但两组中其他并发症的发生率无显著差异。术后血清甲状腺球蛋白水平相似，在2组，短期随访（1年）显示没有复发的超声检查和放射性碘治疗过程中没有异常摄取在任何group.Conclusions：机器人技术的应用，内镜甲状腺切除术可以克服传统的内镜手术的局限性，在PTMC的手术管理。
Objective: To confirm the merits of robotic thyroid surgery by comparing the surgical outcomes of robotic-assisted and conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients.Background: Robot-assisted surgical techniques are widely utilized, and substantially, overcome the limitations of conventional endoscopic surgery. Furthermore, recently, robotic procedures were introduced to the thyroidectomy field.Methods: From November 2001 to July 2009, 1150 patients with PTMC underwent endoscopic thyroidectomy using a gasless, trans-axillary approach. Of these patients, 580 underwent a robotic procedure (the robotic group; RG) and 570 a conventional endoscopic procedure (the conventional endoscopic group; EG). These 2 groups were retrospectively compared in terms of their clinicopathologic characteristics, early surgical outcomes, and surgical completeness.Results: Total thyroidectomy was performed more frequently in the RG. Although mean operation times were not statistically different, the mean number of central nodes retrieved was greater in the RG than in the EG. Mean tumor size were not significantly different in the 2 groups, but the RG showed more frequent central node metastasis and capsular invasion. Tumor and nodal statuses in the RG were more advanced than in the EG. Regarding postoperative complications, transient hypocalcemia was more frequent in the RG, but other complication frequencies were not significantly different in the 2 groups. Postoperative serum thyroglobulin levels were similar in 2 groups, and short-term follow-up (1 year) revealed no recurrence by sonography and no abnormal uptake during radioactive iodine therapy in either group.Conclusions: The application of robotic technology to endoscopic thyroidectomy could overcome the limitations of conventional endoscopic surgery during the surgical management of PTMC.