Surgical Outcomes of Robotic MRND versus Conventional Open MRND for Papillary Thyroid Carcinoma with Lateral Neck Node Metastasis: Comparative Analysis using Propensity Score Matching.
10.16956/kjes.2013.13.4.227
- Author:
Kwang Hyun YOON
1
;
Won Woong KIM
;
Ji Young YOO
;
Eun Jeong BAN
;
Hai Young SON
;
Sang Wook KANG
;
Jong Ju JEONG
;
Kee Hyun NAM
;
Woong Youn CHUNG
;
Cheong Soo PARK
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. oralvanco@yuhs.ac
- Publication Type:Original Article
- Keywords:
Papillary thyroid carcinoma;
Lateral neck metastasis;
Radical neck dissection;
Robot surgery
- MeSH:
Humans;
Length of Stay;
Lymph Nodes;
Methods;
Neck Dissection;
Neck*;
Neoplasm Metastasis*;
Operative Time;
Patient Satisfaction;
Propensity Score*;
Retrospective Studies;
Selection Bias;
Thyroglobulin;
Thyroid Gland*;
Thyroid Neoplasms*
- From:Korean Journal of Endocrine Surgery
2013;13(4):227-233
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: During the past decade, various endoscopic thyroid surgeries have been conducted, each with its own benefits. The incorporation of robotic systems to endoscopic thyroid surgery has improved the visualization and precision of endoscopic techniques. We previously reported our initial experience with robotic modified radical neck dissection (MRND) of papillary thyroid carcinoma (PTC) with lateral neck node metastasis (LNM). The aim of this study was to compare surgical outcomes of robotic vs. conventional open MRND of PTC with LNM using propensity score matching. METHODS: From January 2008 to February 2011, 515 patients with PTC with LNM were enrolled. One hundred patients underwent robotic MRND, and 415 patients underwent conventional open MRND. These two groups were retrospectively compared with respect to their clinicopathological characteristics, surgical outcomes, and surgical completeness. Furthermore, to avoid selection bias, propensity score matching analysis was used to compare surgical outcomes of each group without any compounding factors. RESULTS: The operative time for the robotic MRND was longer than for the open MRND (297.9±60.2 min vs. 212.1±55.6 min, P=0.089). However, the mean numbers of retrieved lymph nodes and mean hospital stay after surgery were similar in the two groups (36.0±12.9 vs. 40.8±13.3, P=0.235), (6.1±1.6 days vs. 6.1±2.1 days, P=0.577). The complication rates were similar between the two groups, and there was no statistical difference in postoperative thyroglobulin levels between groups (0.51±0.83 ng/ml vs. 0.89±2.46 ng/ml, P=0.593). CONCLUSION: According to our study, robotic MRND shows similar surgical outcomes to conventional open MRND after case-matched analyses. We suggest that robotic MRND is an acceptable alternative as an operative method for PTC with LNM, resulting in excellent cosmesis and patient satisfaction.
