Skip to main content
Erschienen in: Surgical Endoscopy 4/2014

01.04.2014

Surgical completeness of robotic thyroidectomy: a prospective comparison with conventional open thyroidectomy in papillary thyroid carcinoma patients

verfasst von: Sohee Lee, Cho Rok Lee, Seung Chul Lee, Seulkee Park, Ha Yan Kim, Haiyoung Son, Sang-Wook Kang, Jong Ju Jeong, Kee-Hyun Nam, Woong Youn Chung, Cheong Soo Park, Arthur Cho

Erschienen in: Surgical Endoscopy | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Using the da Vinci® robotic system, surgeons can complete secure thyroidectomy without noticeable neck scarring. This study compared the surgical completeness of transaxillary robotic thyroidectomy (RT) with conventional open procedures (OT) in treating papillary thyroid carcinoma (PTC) patients.

Materials and methods

From April 2009 through February 2011, 94 PTC patients underwent total thyroidectomy with central compartment neck dissection (CCND) at Yonsei University College of Medicine. All patients received 1.1 GBq radioactive iodine (RAI) ablation, post-therapy whole-body scans (TxWBS), and diagnostic WBS (DxWBS) 1 year later. We prospectively compared patient clinicopathologic characteristics and surgical completeness between the two groups.

Results

Fifty-one patients underwent OT and 43 underwent RT. Mean age was significantly younger in the RT group. Tumor size, capsular-invasion frequency, multifocality, bilaterality, and central nodal metastasis were not different between the two groups. The number of retrieved nodes during CCND did not significantly differ between the groups. There was no significant difference between the OT and RT groups in stimulated thyroglobulin levels acquired during TxWBS and DxWBS. The RAI uptake ratios at TxWBS were significantly higher in the RT group compared with the OT group; however, follow-up DxWBS showed no difference in RAI uptake ratios. Also, the ablation success rate was similar between the two groups. There were no abnormal findings in follow-up neck ultrasonography in either group.

Conclusion

Remnant thyroid tissue ablation after transaxillary RT was successfully managed by 1.1 GBq RAI. RT showed similar surgical completeness versus conventional OT, and provides a safe and feasible surgical option for PTC patients.
Literatur
1.
2.
Zurück zum Zitat Duncan TD, Ejeh IA, Speights F, Rashid QN, Ideis M (2006) Endoscopic transaxillary near total thyroidectomy. JSLS 10(2):206–211PubMedCentralPubMed Duncan TD, Ejeh IA, Speights F, Rashid QN, Ideis M (2006) Endoscopic transaxillary near total thyroidectomy. JSLS 10(2):206–211PubMedCentralPubMed
3.
Zurück zum Zitat Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83(6):875CrossRefPubMed Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83(6):875CrossRefPubMed
4.
Zurück zum Zitat Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2002) Comparative study of thyroidectomies: endoscopic surgery versus conventional open surgery. Surg Endosc 16(12):1741–1745CrossRefPubMed Ikeda Y, Takami H, Sasaki Y, Takayama J, Niimi M, Kan S (2002) Comparative study of thyroidectomies: endoscopic surgery versus conventional open surgery. Surg Endosc 16(12):1741–1745CrossRefPubMed
5.
Zurück zum Zitat Lombardi CP, Raffaelli M, de Crea C, Princi P, Castaldi P, Spaventa A, Salvatori M, Bellantone R (2007) Report on 8 years of experience with video-assisted thyroidectomy for papillary thyroid carcinoma. Surgery 142(6):944–951 discussion 944–951CrossRefPubMed Lombardi CP, Raffaelli M, de Crea C, Princi P, Castaldi P, Spaventa A, Salvatori M, Bellantone R (2007) Report on 8 years of experience with video-assisted thyroidectomy for papillary thyroid carcinoma. Surgery 142(6):944–951 discussion 944–951CrossRefPubMed
6.
Zurück zum Zitat Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D (2001) Minimally invasive video-assisted thyroidectomy. Am J Surg 181(6):567–570CrossRefPubMed Miccoli P, Berti P, Raffaelli M, Conte M, Materazzi G, Galleri D (2001) Minimally invasive video-assisted thyroidectomy. Am J Surg 181(6):567–570CrossRefPubMed
7.
Zurück zum Zitat Miccoli P, Elisei R, Materazzi G, Capezzone M, Galleri D, Pacini F, Berti P, Pinchera A (2002) Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery 132(6):1070–1073 discussion 1073–1074CrossRefPubMed Miccoli P, Elisei R, Materazzi G, Capezzone M, Galleri D, Pacini F, Berti P, Pinchera A (2002) Minimally invasive video-assisted thyroidectomy for papillary carcinoma: a prospective study of its completeness. Surgery 132(6):1070–1073 discussion 1073–1074CrossRefPubMed
8.
Zurück zum Zitat Shimizu K, Akira S, Jasmi AY, Kitamura Y, Kitagawa W, Akasu H, Tanaka S (1999) Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg 188(6):697–703CrossRefPubMed Shimizu K, Akira S, Jasmi AY, Kitamura Y, Kitagawa W, Akasu H, Tanaka S (1999) Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg 188(6):697–703CrossRefPubMed
9.
Zurück zum Zitat Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16(4):226–231CrossRefPubMed Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16(4):226–231CrossRefPubMed
10.
Zurück zum Zitat Jeong JJ, Kang SW, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients. J Surg Oncol 100(6):477–480CrossRefPubMed Jeong JJ, Kang SW, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients. J Surg Oncol 100(6):477–480CrossRefPubMed
11.
Zurück zum Zitat Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Gasless endoscopic thyroidectomy using trans-axillary approach; surgical outcome of 581 patients. Endocr J 56(3):361–369CrossRefPubMed Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Gasless endoscopic thyroidectomy using trans-axillary approach; surgical outcome of 581 patients. Endocr J 56(3):361–369CrossRefPubMed
12.
Zurück zum Zitat Lee S, Ryu HR, Park JH, Kim KH, Kang SW, Jeong JJ, Nam KH, Chung WY, Park CS (2011) Excellence in robotic thyroid surgery: a comparative study of robot-assisted versus conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma patients. Ann Surg 253(6):1060–1066CrossRefPubMed Lee S, Ryu HR, Park JH, Kim KH, Kang SW, Jeong JJ, Nam KH, Chung WY, Park CS (2011) Excellence in robotic thyroid surgery: a comparative study of robot-assisted versus conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma patients. Ann Surg 253(6):1060–1066CrossRefPubMed
13.
Zurück zum Zitat Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146(6):1048–1055CrossRefPubMed Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146(6):1048–1055CrossRefPubMed
14.
Zurück zum Zitat Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209(2):e1–e7CrossRefPubMed Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209(2):e1–e7CrossRefPubMed
15.
Zurück zum Zitat Tae K, Kim KY, Yun BR, Ji YB, Park CW, Kim DS, Kim TW (2012) Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc 26(7):1871–1877CrossRefPubMed Tae K, Kim KY, Yun BR, Ji YB, Park CW, Kim DS, Kim TW (2012) Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc 26(7):1871–1877CrossRefPubMed
16.
Zurück zum Zitat Tae K, Ji YB, Cho SH, Lee SH, Kim DS, Kim TW (2012) Early surgical outcomes of robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach for papillary thyroid carcinoma: 2 years’ experience. Head Neck 34(5):617–625CrossRefPubMed Tae K, Ji YB, Cho SH, Lee SH, Kim DS, Kim TW (2012) Early surgical outcomes of robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach for papillary thyroid carcinoma: 2 years’ experience. Head Neck 34(5):617–625CrossRefPubMed
17.
Zurück zum Zitat Lee S, Ryu HR, Park JH, Kim KH, Kang SW, Jeong JJ, Nam KH, Chung WY, Park CS (2012) Early surgical outcomes comparison between robotic and conventional open thyroid surgery for papillary thyroid microcarcinoma. Surgery 151(5):724–730CrossRefPubMed Lee S, Ryu HR, Park JH, Kim KH, Kang SW, Jeong JJ, Nam KH, Chung WY, Park CS (2012) Early surgical outcomes comparison between robotic and conventional open thyroid surgery for papillary thyroid microcarcinoma. Surgery 151(5):724–730CrossRefPubMed
18.
Zurück zum Zitat Lee J, Yun JH, Nam KH, Choi UJ, Chung WY, Soh EY (2011) Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study. Surg Endosc 25(3):906–912CrossRefPubMed Lee J, Yun JH, Nam KH, Choi UJ, Chung WY, Soh EY (2011) Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study. Surg Endosc 25(3):906–912CrossRefPubMed
19.
Zurück zum Zitat Lee J, Nah KY, Kim RM, Ahn YH, Soh EY, Chung WY (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 24(12):3186–3194CrossRefPubMed Lee J, Nah KY, Kim RM, Ahn YH, Soh EY, Chung WY (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 24(12):3186–3194CrossRefPubMed
20.
Zurück zum Zitat Lee J, Na KY, Kim RM, Oh Y, Lee JH, Lee JS, Kim CH, Soh EY, Chung WY (2012) Postoperative functional voice changes after conventional open or robotic thyroidectomy: a prospective trial. Ann Surg Oncol 19(9):2963–2970CrossRefPubMed Lee J, Na KY, Kim RM, Oh Y, Lee JH, Lee JS, Kim CH, Soh EY, Chung WY (2012) Postoperative functional voice changes after conventional open or robotic thyroidectomy: a prospective trial. Ann Surg Oncol 19(9):2963–2970CrossRefPubMed
21.
Zurück zum Zitat Kandil EH, Noureldine SI, Yao L, Slakey DP (2012) Robotic transaxillary thyroidectomy: an examination of the first one hundred cases. J Am Coll Surg 214(4):558–564CrossRefPubMed Kandil EH, Noureldine SI, Yao L, Slakey DP (2012) Robotic transaxillary thyroidectomy: an examination of the first one hundred cases. J Am Coll Surg 214(4):558–564CrossRefPubMed
22.
Zurück zum Zitat Landry CS, Grubbs EG, Morris GS, Turner NS, Holsinger FC, Lee JE, Perrier ND (2011) Robot assisted transaxillary surgery (RATS) for the removal of thyroid and parathyroid glands. Surgery 149(4):549–555CrossRefPubMed Landry CS, Grubbs EG, Morris GS, Turner NS, Holsinger FC, Lee JE, Perrier ND (2011) Robot assisted transaxillary surgery (RATS) for the removal of thyroid and parathyroid glands. Surgery 149(4):549–555CrossRefPubMed
23.
Zurück zum Zitat Ciabatti PG, Burali G, D’Ascanio L (2012) Single-incision robot-assisted transaxillary surgery for early-stage papillary thyroid cancer. Ann Otol Rhinol Laryngol 121(12):811–815CrossRefPubMed Ciabatti PG, Burali G, D’Ascanio L (2012) Single-incision robot-assisted transaxillary surgery for early-stage papillary thyroid cancer. Ann Otol Rhinol Laryngol 121(12):811–815CrossRefPubMed
24.
Zurück zum Zitat Aliyev S, Taskin HE, Agcaoglu O, Aksoy E, Milas M, Siperstein A, Berber E (2013) Robotic transaxillary total thyroidectomy through a single axillary incision. Surgery 153(5):705–710CrossRefPubMed Aliyev S, Taskin HE, Agcaoglu O, Aksoy E, Milas M, Siperstein A, Berber E (2013) Robotic transaxillary total thyroidectomy through a single axillary incision. Surgery 153(5):705–710CrossRefPubMed
25.
Zurück zum Zitat Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23(11):2399–2406CrossRefPubMed Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23(11):2399–2406CrossRefPubMed
26.
Zurück zum Zitat Ryu HR, Kang SW, Lee SH, Rhee KY, Jeong JJ, Nam KH, Chung WY, Park CS (2010) Feasibility and safety of a new robotic thyroidectomy through a gasless, transaxillary single-incision approach. J Am Coll Surg 211(3):e13–e19CrossRefPubMed Ryu HR, Kang SW, Lee SH, Rhee KY, Jeong JJ, Nam KH, Chung WY, Park CS (2010) Feasibility and safety of a new robotic thyroidectomy through a gasless, transaxillary single-incision approach. J Am Coll Surg 211(3):e13–e19CrossRefPubMed
27.
Zurück zum Zitat Lee KE, do Koo H, Im HJ, Park SK, Choi JY, Paeng JC, Chung JK, Oh SK, Youn YK (2011) Surgical completeness of bilateral axillo-breast approach robotic thyroidectomy: comparison with conventional open thyroidectomy after propensity score matching. Surgery 150(6):1266–1274CrossRefPubMed Lee KE, do Koo H, Im HJ, Park SK, Choi JY, Paeng JC, Chung JK, Oh SK, Youn YK (2011) Surgical completeness of bilateral axillo-breast approach robotic thyroidectomy: comparison with conventional open thyroidectomy after propensity score matching. Surgery 150(6):1266–1274CrossRefPubMed
28.
Zurück zum Zitat Im HJ, do Koo H, Paeng JC, Lee KE, Chung YS, Lim I, Lee DS, Chung JK, Youn YK (2012) Evaluation of surgical completeness in endoscopic thyroidectomy compared with open thyroidectomy with regard to remnant ablation. Clin Nucl Med 37(2):148–151CrossRefPubMed Im HJ, do Koo H, Paeng JC, Lee KE, Chung YS, Lim I, Lee DS, Chung JK, Youn YK (2012) Evaluation of surgical completeness in endoscopic thyroidectomy compared with open thyroidectomy with regard to remnant ablation. Clin Nucl Med 37(2):148–151CrossRefPubMed
29.
Zurück zum Zitat Fratkin MJ, Newsome HH Jr, Sharpe AR Jr, Tatum JL (1983) Cervical distribution of iodine 131 following total thyroidectomy for thyroid cancer. Arch Surg 118(7):864–867CrossRefPubMed Fratkin MJ, Newsome HH Jr, Sharpe AR Jr, Tatum JL (1983) Cervical distribution of iodine 131 following total thyroidectomy for thyroid cancer. Arch Surg 118(7):864–867CrossRefPubMed
30.
Zurück zum Zitat Leger FA, Izembart M, Dagousset F, Barritault L, Baillet G, Chevalier A, Clerc J (1998) Decreased uptake of therapeutic doses of iodine-131 after 185 MBq iodine-131 diagnostic imaging for thyroid remnants in differentiated thyroid carcinoma. Eur J Nucl Med 25(3):242–246CrossRefPubMed Leger FA, Izembart M, Dagousset F, Barritault L, Baillet G, Chevalier A, Clerc J (1998) Decreased uptake of therapeutic doses of iodine-131 after 185 MBq iodine-131 diagnostic imaging for thyroid remnants in differentiated thyroid carcinoma. Eur J Nucl Med 25(3):242–246CrossRefPubMed
31.
Zurück zum Zitat Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11):1167–1214CrossRefPubMed Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM (2009) Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11):1167–1214CrossRefPubMed
32.
Zurück zum Zitat Lee KE, Kim E, Koo DH, Choi JY, Kim KH, Youn YK (2013) Robotic thyroidectomy by bilateral axillo-breast approach: review of 1026 cases and surgical completeness. Surg Endosc 27(8):2955–2962CrossRefPubMed Lee KE, Kim E, Koo DH, Choi JY, Kim KH, Youn YK (2013) Robotic thyroidectomy by bilateral axillo-breast approach: review of 1026 cases and surgical completeness. Surg Endosc 27(8):2955–2962CrossRefPubMed
33.
Zurück zum Zitat Schlumberger M, Catargi B, Borget I, Deandreis D, Zerdoud S, Bridji B, Bardet S, Leenhardt L, Bastie D, Schvartz C, Vera P, Morel O, Benisvy D, Bournaud C, Bonichon F, Dejax C, Toubert ME, Leboulleux S, Ricard M, Benhamou E (2012) Strategies of radioiodine ablation in patients with low-risk thyroid cancer. N Engl J Med 366(18):1663–1673CrossRefPubMed Schlumberger M, Catargi B, Borget I, Deandreis D, Zerdoud S, Bridji B, Bardet S, Leenhardt L, Bastie D, Schvartz C, Vera P, Morel O, Benisvy D, Bournaud C, Bonichon F, Dejax C, Toubert ME, Leboulleux S, Ricard M, Benhamou E (2012) Strategies of radioiodine ablation in patients with low-risk thyroid cancer. N Engl J Med 366(18):1663–1673CrossRefPubMed
34.
Zurück zum Zitat Mallick U, Harmer C, Yap B, Wadsley J, Clarke S, Moss L, Nicol A, Clark PM, Farnell K, McCready R, Smellie J, Franklyn JA, John R, Nutting CM, Newbold K, Lemon C, Gerrard G, Abdel-Hamid A, Hardman J, Macias E, Roques T, Whitaker S, Vijayan R, Alvarez P, Beare S, Forsyth S, Kadalayil L, Hackshaw A (2012) Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer. N Engl J Med 366(18):1674–1685CrossRefPubMed Mallick U, Harmer C, Yap B, Wadsley J, Clarke S, Moss L, Nicol A, Clark PM, Farnell K, McCready R, Smellie J, Franklyn JA, John R, Nutting CM, Newbold K, Lemon C, Gerrard G, Abdel-Hamid A, Hardman J, Macias E, Roques T, Whitaker S, Vijayan R, Alvarez P, Beare S, Forsyth S, Kadalayil L, Hackshaw A (2012) Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer. N Engl J Med 366(18):1674–1685CrossRefPubMed
35.
Zurück zum Zitat Yi O, Yoon JH, Lee YM, Sung TY, Chung KW, Kim TY, Kim WB, Shong YK, Ryu JS, Hong SJ (2013) Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol 20(6):1927–1933CrossRefPubMed Yi O, Yoon JH, Lee YM, Sung TY, Chung KW, Kim TY, Kim WB, Shong YK, Ryu JS, Hong SJ (2013) Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol 20(6):1927–1933CrossRefPubMed
36.
Zurück zum Zitat Cailleux AF, Baudin E, Travagli JP, Ricard M, Schlumberger M (2000) Is diagnostic iodine-131 scanning useful after total thyroid ablation for differentiated thyroid cancer? J Clin Endocrinol Metab 85(1):175–178CrossRefPubMed Cailleux AF, Baudin E, Travagli JP, Ricard M, Schlumberger M (2000) Is diagnostic iodine-131 scanning useful after total thyroid ablation for differentiated thyroid cancer? J Clin Endocrinol Metab 85(1):175–178CrossRefPubMed
37.
Zurück zum Zitat Pacini F, Capezzone M, Elisei R, Ceccarelli C, Taddei D, Pinchera A (2002) Diagnostic 131-iodine whole-body scan may be avoided in thyroid cancer patients who have undetectable stimulated serum Tg levels after initial treatment. J Clin Endocrinol Metab 87(4):1499–1501CrossRefPubMed Pacini F, Capezzone M, Elisei R, Ceccarelli C, Taddei D, Pinchera A (2002) Diagnostic 131-iodine whole-body scan may be avoided in thyroid cancer patients who have undetectable stimulated serum Tg levels after initial treatment. J Clin Endocrinol Metab 87(4):1499–1501CrossRefPubMed
38.
Zurück zum Zitat Salvatori M, Raffaelli M, Castaldi P, Treglia G, Rufini V, Perotti G, Lombardi CP, Rubello D, Ardito G, Bellantone R (2007) Evaluation of the surgical completeness after total thyroidectomy for differentiated thyroid carcinoma. Eur J Surg Oncol 33(5):648–654CrossRefPubMed Salvatori M, Raffaelli M, Castaldi P, Treglia G, Rufini V, Perotti G, Lombardi CP, Rubello D, Ardito G, Bellantone R (2007) Evaluation of the surgical completeness after total thyroidectomy for differentiated thyroid carcinoma. Eur J Surg Oncol 33(5):648–654CrossRefPubMed
Metadaten
Titel
Surgical completeness of robotic thyroidectomy: a prospective comparison with conventional open thyroidectomy in papillary thyroid carcinoma patients
verfasst von
Sohee Lee
Cho Rok Lee
Seung Chul Lee
Seulkee Park
Ha Yan Kim
Haiyoung Son
Sang-Wook Kang
Jong Ju Jeong
Kee-Hyun Nam
Woong Youn Chung
Cheong Soo Park
Arthur Cho
Publikationsdatum
01.04.2014
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 4/2014
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3303-y

Weitere Artikel der Ausgabe 4/2014

Surgical Endoscopy 4/2014 Zur Ausgabe

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.