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American Head & Neck Society
Annual Meeting, April 10-11, 2013
JW Marriott Grande Lakes
Orlando, Florida
During the
Combined Otolaryngology Spring Meeting
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ROBOT-ASSISTED COMPREHENSIVE NECK DISSECTION VIA A TRANSAXILLARY AND RETROAURICULAR (“TARA”) APPROACH IN PAPILLARY THYROID CANCER WITH CERVICAL LYMPH NODE METASTASES: A COMPARATIVE STUDY WITH THE TRANSAXILLARY APPROACH
| Presentation: |
S012 |
| Topic: |
Clinical - Thyroid / Parathyroid |
| Type: |
Oral Presentation |
| Date: |
Wednesday, April 10, 2013 |
| Session: |
04:00 PM - 05:00 PM Robotics |
| Authors: |
Won Shik Kim, MD, Yoon Woo Koh, MD, PhD, Jae Wook Kim, MD, Hyun Jun Hong, MD, Hyung Kwon Byeon, MD, Young Min Park, MD, Hyo Jin Chung, MD, Sang Chul Park, MD, Michelle J. Suh, MD, Eun Jung Lee, MD, Eun Chang Choi, MD, PhD |
| Institution(s): |
1Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea 2Department of Otolaryngology–Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul, Korea |
Background: Cervical lymph node metastases are frequently encountered in the management of papillary thyroid carcinoma (PTC). Recently, robot-assisted neck dissection (ND) using a gasless transaxillary (TA) approach in thyroid cancer patients with lateral neck node metastases was studied and proven to be feasible. Here, we devised a modified transaxillary and retroauricular (TARA) approach with the addition of a retroauricular incision to the TA approach for the clearance of level II lymph nodes. The aim of this study was to compare the surgical outcomes of TARA vs. TA in the management of cervical lymph node metastases in PTC.
Methods: From October 2010 to May 2012, a total of 29 patients with PTC underwent robotic total thyroidectomy with central compartment ND, and robot-assisted modified radical ND except level I. Among the patients, 15 unilateral and 3 bilateral NDs were performed via the TARA approach, and 11 unilateral NDs were performed via the TA approach.
Results: The TA group consisted of eight females and three males, with a mean age of 43.2 years. The TARA group consisted of twelve females and six males, with a mean age of 32.6 years. There was no significant difference in operation time for ND between both groups. However, the time from skin incision to the point immediately before docking of the robotic arms was significantly longer in the TARA group, and the console time was longer in the TA group. Level II and level IV specimens in the TARA group contained a relatively larger number of lymph nodes than those in the TA group. There were no significant differences in the development of postoperative complications between both groups. All NDs were successfully performed via a robot-assisted technique.
Conclusions: Robot-assisted NDs were successfully performed via a novel TARA approach in PTC patients with cervical lymph node metastases. The surgical outcomes of robot-assisted ND via a TARA approach were comparable or even superior to those of robot-assisted ND via the transaxillary approach, especially for upper-level ND. TARA is a useful, alternative approach for addressing cervical lymph node metastases in selected cases of PTC.
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