경부-액와접근법을 이용한 내시경 갑상선절제술과 로봇하 갑상선절제술의 비교 및 고찰
Comparison Study of Endoscopic Thyroidectomy Versus Robot-assisted Thyroidectomy by a Cervico-transaxillary Approach
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초록
Purpose: Endoscopic and robot-assisted thyroidectomy has shown rapid development worldwide. In addition, there is no treatment of choice for thyroidectomy as usual. We propose an endoscopic thyroidectomy using a cervico-transaxillary approach, comparing its results with those of robot-assisted thyroidectomy. We present this study in order to provide advantages and disadvantages. Methods: Between January 2010 and March 2012, 132 patients were recruited with clinicopathological data for this study. We divided patients into two groups, the endoscopic and the robot groups, with respect to their clinical characteristics, surgical outcomes. The outcomes were evaluated in terms of operation time, estimated blood loss, hemovac amount, hospital stay, and number of lymph nodes harvested. Results: A total of 132 patients (male 6 and female 126) were recruited with clinicopathological data for this study. Of these, 78 patients underwent endoscopic thyroidectomy (the endo group) and 54 underwent robot-assisted thyroidectomy (the robot group) using a cervico-transaxillary approach. The two groups did not differ significantly in terms of age, estimated blood loss, and complications. None of the patients experienced severe complications. Conclusion: Results of the preliminary comparison in this study show that both approaches are safe and feasible, with similar results. However, a smaller hemovac amount was observed with endoscopic thyroidectomy, compared to robot-assisted thyroidectomy. In order to cut costs, part of robot-assisted thyroidectomy could be replaced by endoscopic thyroidectomy.
Abstract
Purpose: Endoscopic and robot-assisted thyroidectomy has shown rapid development worldwide. In addition, there is no treatment of choice for thyroidectomy as usual. We propose an endoscopic thyroidectomy using a cervico-transaxillary approach, comparing its results with those of robot-assisted thyroidectomy. We present this study in order to provide advantages and disadvantages. Methods: Between January 2010 and March 2012, 132 patients were recruited with clinicopathological data for this study. We divided patients into two groups, the endoscopic and the robot groups, with respect to their clinical characteristics, surgical outcomes. The outcomes were evaluated in terms of operation time, estimated blood loss, hemovac amount, hospital stay, and number of lymph nodes harvested. Results: A total of 132 patients (male 6 and female 126) were recruited with clinicopathological data for this study. Of these, 78 patients underwent endoscopic thyroidectomy (the endo group) and 54 underwent robot-assisted thyroidectomy (the robot group) using a cervico-transaxillary approach. The two groups did not differ significantly in terms of age, estimated blood loss, and complications. None of the patients experienced severe complications. Conclusion: Results of the preliminary comparison in this study show that both approaches are safe and feasible, with similar results. However, a smaller hemovac amount was observed with endoscopic thyroidectomy, compared to robot-assisted thyroidectomy. In order to cut costs, part of robot-assisted thyroidectomy could be replaced by endoscopic thyroidectomy.
참고문헌 (30)
- Gagner M, "Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism", Br J Surg, 83, pp.875~ (1996)
- Hüscher CS, "Endoscopic right thyroid lobectomy", Surg Endosc, 11, pp.877~ (1997)
- Tae K, "Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences", Surg Endosc, 25, pp.221~228 (2011)
- 정웅윤, "Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy", SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 24, pp.3186~3194, SPRINGER
- Gutt CN, "Robot-assisted abdominal surgery", Br J Surg, 91, pp.1390~1397 (2004)
- Lobe TE, "Novel uses of surgical robotics in head and neck surgery", J Laparoendosc Adv Surg Tech A, 15, pp.647~652 (2005)
- Miyano G, "Bilateral transaxillary endoscopic total thyroidectomy", J Pediatr Surg, 43, pp.299~303 (2008)
- Savitt MA, "Application of robotic-assisted techniques to the surgical evaluation and treatment of the anterior mediastinum", Ann Thorac Surg, 79, pp.450~455 (2005)
- Ikeda Y, "Endoscopic resection of thyroid tumors by the axillary approach", J Cardiovasc Surg (Torino), 41, pp.791~792 (2000)
- Kang SW, "Gasless endoscopic thyroidectomy using trans-axillary approach; surgical outcome of 581 patients", Endocr J, 56, pp.361~369 (2009)
- Lombardi CP, "Video-assisted thyroidectomy: report of a 7-year experience in Rome", Langenbecks Arch Surg, 391, pp.174~177 (2006)
- Ikeda Y, "Total endoscopic thyroidectomy: axillary or anterior chest approach", Biomed Pharmacother, 56(1), pp.72s~78s (2002)
- 정웅윤, "Gasless endoscopic thyroidectomy via an axillary approach: Experience of 30 cases", SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 16, pp.226~231
- 이규언, "Endoscopic thyroidectomy with the da vinci robot system using the bilateral axillary breast approach (BABA) technique: Our initial experience", Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, 19(3), pp.e71~e75, Lippincott Williams & Wilkins Ltd.
- Li Z, "Endoscopic lateral neck dissection via breast approach for papillary thyroid carcinoma: a preliminary report", Surg Endosc, 25, pp.890~896 (2011)
- Youben F, "Trans-areola single-site endoscopic thyroidectomy: pilot study of 35 cases", Surg Endosc, 26, pp.939~947 (2012)
- Cordón C, "A randomized, prospective, parallel group study comparing the Harmonic Scalpel to electrocautery in thyroidectomy", Surgery, 137, pp.337~341 (2005)
- Kang SW, "Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients", Surg Endosc, 23, pp.2399~2406 (2009)
- Kang SW, "Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach", J Am Coll Surg, 209, pp.e1~e7 (2009)
- Landry CS, "Robot assisted transaxillary surgery (RATS) for the removal of thyroid and parathyroid glands", Surgery, 149, pp.549~555 (2011)
- Terris DJ, "Robotic facelift thyroidectomy: II. Clinical feasibility and safety", Laryngoscope, 121, pp.1636~1641 (2011)
- Lombardi CP, "Minimally invasive video-assisted functional lateral neck dissection for metastatic papillary thyroid carcinoma", Am J Surg, 193, pp.114~118 (2007)
- Hegazy MA, "Minimally invasive video-assisted thyroidectomy for small follicular thyroid nodules", World J Surg, 31, pp.1743~1750 (2007)
- Chen GZ, "Systematic comparison of cervical and extra-cervical surgical approaches for endoscopic thyroidectomy", Surg Today, 42, pp.835~841 (2012)
- Sahm M, "Long-term cosmetic results after minimally invasive video- assisted thyroidectomy", Surg Endosc, 25, pp.3202~3208 (2011)
- Lee J, "Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study", Surg Endosc, 25, pp.906~912 (2011)
- Kandil E, "Transaxillary gasless robotic thyroidectomy: a single surgeon's experience in North America", Arch Otolaryngol Head Neck Surg, 138, pp.113~117 (2012)
- Zhou J, "Endoscopic thyroidectomy for bilateral thyroid diseases: safety and effectiveness", J Craniofac Surg, 23, pp.565~570 (2012)
- Kataoka H, "Total video endoscopic thyroidectomy viathe anterior chest approach using the cervical region-lifting method", Biomed Pharmacother, 56(1), pp.68s~71s (2002)
- Kim JS, "A clinical analysis of 100 cases of gasless endoscopic thyroidectomy", Surgery, 63, pp.18~22 (2002)