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A comparative study of the surgical outcomes of robotic and conventional open modified radical neck dissection for papillary thyroid carcinoma with lateral neck node metastasis

机译：机器人和常规开放式改良根治性颈淋巴结清扫术治疗甲状腺乳头状癌伴侧颈淋巴结转移的疗效比较

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Background: Several endoscopic modified radical neck dissections (MRND) have been conducted since the introduction of the endoscopic technique to thyroid surgery with the aim of avoiding a long cervical scar. Furthermore, the recent introduction of surgical robotic systems has increased the precision of endoscopic techniques. The aim of this study was to evaluate and compare the early surgical outcomes of robotic and conventional open MRND for papillary thyroid carcinoma (PTC) with lateral neck node metastasis (LNM). Methods: From January 2009 to May 2010, 165 patients with PTC underwent bilateral total thyroidectomy with central compartment neck dissection and ipsilateral MRND. Of these patients, 56 formed the robotic procedure group (RG) and 109 the conventional open procedure group. These two groups were retrospectively compared with respect to their clinicopathological characteristics, early surgical outcomes, and surgical completeness. Results: The operative time was longer, mean tumor size was smaller, mean age was lower, and disease stage was earlier in the RG. However, mean numbers of retrieved lymph nodes were similar in the two groups, and mean hospital stay after surgery was shorter in the RG. Furthermore, complication rates were similar in the two groups, and there was no statistical difference in postoperative Tg levels between the groups. Conclusions: Robotic MRND was found to be similar to conventional open MRND in terms of early surgical outcomes and surgical completeness but leaves no scar on the neck area. Robotic MRND can be viewed as an acceptable alternative method in low-risk PTC with LNM.
机译：背景：自从将内窥镜技术引入甲状腺手术以来，已经进行了几种内窥镜改良根治性颈淋巴清扫术（MRND），目的是避免长颈椎疤痕。此外，最近引入的外科手术机器人系统提高了内窥镜技术的精度。这项研究的目的是评估和比较机器人和常规开放式MRND对乳头状甲状腺癌（PTC）伴侧颈淋巴结转移（LNM）的早期手术效果。方法：2009年1月至2010年5月，对165例PTC患者进行了双侧全甲状腺切除术，并进行了中央室颈清扫术和同侧MRND。在这些患者中，有56人组成了机器人程序组（RG），而有109人组成了常规开放程序组。回顾性比较这两组患者的临床病理特征，早期手术结局和手术完整性。结果：RG的手术时间更长，平均肿瘤尺寸更小，平均年龄更低，疾病阶段更早。然而，两组的平均回收淋巴结数目相似，并且RG术后的平均住院时间较短。此外，两组的并发症发生率相似，两组之间的术后Tg水平无统计学差异。结论：发现机器人MRND在早期手术效果和手术完整性方面与常规开放式MRND类似，但在颈部无疤痕。在具有LNM的低风险PTC中，机器人MRND可被视为一种可接受的替代方法。

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