Robotic Vs Conventional OpenApproaches to Thyroid Disease:A Comparison of PostoperativeOutcomes
Pier Guido Ciabatti, Francesca Romana Fiorini*, Giulia Burali, Roberto Santoro, Christina Cambi and Oreste Gallo
Abstract:
Background: Robot-assisted transaxillary thyroid surgery (RATS) and conventional open thyroidectomy (COT) represent two valid alternatives for treating thyroid disease. We compared postoperative outcomes and complications in patients submitted to thyroid lobectomy and total thyroidectomy via RATS or COT for benign diseases.
Methods: We selected 274 consecutive patients submitted to thyroid lobectomy or total thyroidectomy at the Otolaryngology Department of Arezzo and Florence University from 2011 to 2014, with similar clinical characteristics: female gender and benign thyroid disease. We used the Fisher exact test to compare mean operative time, hospital length of stay (HLS), postoperative histopathology diagnosis, complications and postoperative pain in patients submitted to lobectomy via RATS (n=58, 21.16%) and COT (n=99, 36.13%), and in patients submitted to total thyroidectomy via RATS (n=39, 14.23%) and COT (n=78, 28.46%).
Results: Mean operative time was not increased in patients submitted to lobectomy or total thyroidectomy via RATS (p=0.87), while HLS and postoperative pain were reduced in both groups (p<0.0001).
The incidence of postoperative complications was 0.6% in the thyroid lobectomy group. The postoperative incidence of hemorrhage, hypocalcaemia and transient recurrent laryngeal nerve paralysis in the total thyroidectomy group was 5.9% and did not differ significantly in patients operated via RATS or COT (p=0.42).
Conclusions: RATS are comparable to COT in terms of operative time and postoperative complications, while HLS and postoperative pain seem to be reduced. Prospective trials evaluating cost, quality of life and patient satisfaction are needed in order to define the real advantages and applicability of these procedures.
Pier Guido Ciabatti, Francesca Romana Fiorini*, Giulia Burali, Roberto Santoro, Christina Cambi and Oreste Gallo
Abstract:
Background: Robot-assisted transaxillary thyroid surgery (RATS) and conventional open thyroidectomy (COT) represent two valid alternatives for treating thyroid disease. We compared postoperative outcomes and complications in patients submitted to thyroid lobectomy and total thyroidectomy via RATS or COT for benign diseases.
Methods: We selected 274 consecutive patients submitted to thyroid lobectomy or total thyroidectomy at the Otolaryngology Department of Arezzo and Florence University from 2011 to 2014, with similar clinical characteristics: female gender and benign thyroid disease. We used the Fisher exact test to compare mean operative time, hospital length of stay (HLS), postoperative histopathology diagnosis, complications and postoperative pain in patients submitted to lobectomy via RATS (n=58, 21.16%) and COT (n=99, 36.13%), and in patients submitted to total thyroidectomy via RATS (n=39, 14.23%) and COT (n=78, 28.46%).
Results: Mean operative time was not increased in patients submitted to lobectomy or total thyroidectomy via RATS (p=0.87), while HLS and postoperative pain were reduced in both groups (p<0.0001).
The incidence of postoperative complications was 0.6% in the thyroid lobectomy group. The postoperative incidence of hemorrhage, hypocalcaemia and transient recurrent laryngeal nerve paralysis in the total thyroidectomy group was 5.9% and did not differ significantly in patients operated via RATS or COT (p=0.42).
Conclusions: RATS are comparable to COT in terms of operative time and postoperative complications, while HLS and postoperative pain seem to be reduced. Prospective trials evaluating cost, quality of life and patient satisfaction are needed in order to define the real advantages and applicability of these procedures.
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