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Published in: World Journal of Surgery 6/2014

01-06-2014

Cosmetic Result and Overall Satisfaction after Minimally Invasive Video-assisted Thyroidectomy (MIVAT) versus Robot-assisted Transaxillary Thyroidectomy (RATT): A Prospective Randomized Study

Authors: Gabriele Materazzi, Lorenzo Fregoli, Gabriele Manzini, Angelo Baggiani, Mario Miccoli, Paolo Miccoli

Published in: World Journal of Surgery | Issue 6/2014

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Abstract

Background

No studies have compared robot-assisted transaxillary thyroidectomy (RATT) and minimally invasive video-assisted thyroidectomy (MIVAT) regarding cosmetic outcome and satisfaction

Methods

Patients matching the inclusion criteria (benign nodule less than 4 cm and thyroid volume less than 30 mL) were randomly allotted to undergo MIVAT (group A) or RATT (group B). Cosmetic result, overall satisfaction, operative time, and complications were evaluated.

Results

A total of 62 patients underwent hemithyroidectomy (30 in group A and 32 in group B). All patients were women, with the exception of one man in each group. The mean patient age was 36.9 years (group A) and 32.5 years (group B). Total operative time (intubation–extubation) was shorter in group A (71.6 min) than in group B (120.4 min). Complications included one transient laryngeal nerve injury in each group and one subcutaneous hematoma in group B. Postoperative hospital stay was longer in group B (1.85 days) than in group A (1.15 days). On the PASQ questionnaire, “scar appearance” and “satisfaction with appearance” scores were better in group A than in group B. In the Short Form (SF-36) 36-Item Health Survey Questionnaire, domains of “social activity” and “general health” were better in group B than in group A, whereas “bodily pain” scored higher in group B than in group A.

Conclusions

RATT seems not to supersede MIVAT in terms of satisfaction when comparing two groups of patients undergoing thyroidectomy for benign disease.
Literature
1.
go back to reference Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875PubMedCrossRef Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875PubMedCrossRef
2.
go back to reference Ikeda Y, Takami H, Niimi M et al (2002) Endoscopic thyroidectomy and parathyroidectomy by the axillary approach. A preliminary report. Surg Endosc 16:92–95PubMedCrossRef Ikeda Y, Takami H, Niimi M et al (2002) Endoscopic thyroidectomy and parathyroidectomy by the axillary approach. A preliminary report. Surg Endosc 16:92–95PubMedCrossRef
3.
go back to reference Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16:226–231PubMedCrossRef Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16:226–231PubMedCrossRef
4.
go back to reference Ohgami M, Ishii S, Arisawa Y et al (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4PubMed Ohgami M, Ishii S, Arisawa Y et al (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10:1–4PubMed
5.
go back to reference Cho YU, Park IJ, Choi KH et al (2007) Gasless endoscopic thyroidectomy via an anterior chest wall approach using a flap-lifting system. Yonsei Med J 48:480–487PubMedCentralPubMedCrossRef Cho YU, Park IJ, Choi KH et al (2007) Gasless endoscopic thyroidectomy via an anterior chest wall approach using a flap-lifting system. Yonsei Med J 48:480–487PubMedCentralPubMedCrossRef
6.
go back to reference Bärlehner E, Benhidjeb T (2007) Cervical scarless endoscopic thyroidectomy: axillo-bilateral-breast approach (ABBA). Surg Endosc 22:154–157PubMedCrossRef Bärlehner E, Benhidjeb T (2007) Cervical scarless endoscopic thyroidectomy: axillo-bilateral-breast approach (ABBA). Surg Endosc 22:154–157PubMedCrossRef
8.
go back to reference Shan YZ, Zhou LM, Yu ZF et al (2012) Comparison between transareola single site endoscopic thyroidectomy and minimally invasive video-assisted thyroidectomy. J Int Med Res 40:2213–2219PubMedCrossRef Shan YZ, Zhou LM, Yu ZF et al (2012) Comparison between transareola single site endoscopic thyroidectomy and minimally invasive video-assisted thyroidectomy. J Int Med Res 40:2213–2219PubMedCrossRef
9.
go back to reference Ikeda Y, Takami H, Sasaki Y et al (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195PubMedCrossRef Ikeda Y, Takami H, Sasaki Y et al (2003) Clinical benefits in endoscopic thyroidectomy by the axillary approach. J Am Coll Surg 196:189–195PubMedCrossRef
10.
go back to reference Ikeda Y, Takami H, Sasaki Y et al (2002) Comparative study of thyroidectomies. Endoscopic surgery versus conventional open surgery. Surg Endosc 16:1741–1745PubMedCrossRef Ikeda Y, Takami H, Sasaki Y et al (2002) Comparative study of thyroidectomies. Endoscopic surgery versus conventional open surgery. Surg Endosc 16:1741–1745PubMedCrossRef
13.
go back to reference Kang SW, Jeong JJ, Yun JS et al (2009) Gasless endoscopic thyroidectomy using transaxillary approach: surgical outcome of 581 patients. Endocr J 56:361–369PubMedCrossRef Kang SW, Jeong JJ, Yun JS et al (2009) Gasless endoscopic thyroidectomy using transaxillary approach: surgical outcome of 581 patients. Endocr J 56:361–369PubMedCrossRef
14.
go back to reference Ikeda Y, Takami H, Sasaki Y et al (2000) Endoscopic neck surgery by axillary approach. J Am Coll Surg 191:336–340PubMedCrossRef Ikeda Y, Takami H, Sasaki Y et al (2000) Endoscopic neck surgery by axillary approach. J Am Coll Surg 191:336–340PubMedCrossRef
15.
go back to reference Miccoli P, Berti P, Conte M et al (1999) Minimally invasive surgery for small thyroid nodules: preliminary report. J Endocrinol Invest 22:849–851PubMedCrossRef Miccoli P, Berti P, Conte M et al (1999) Minimally invasive surgery for small thyroid nodules: preliminary report. J Endocrinol Invest 22:849–851PubMedCrossRef
16.
go back to reference Terris DJ, Angelos P, Steward DL et al (2008) Minimally invasive video assisted thyroidectomy: a multiinstitutional North American experience. Arch Otolaryngol Head Neck Surg 134:81–84PubMedCrossRef Terris DJ, Angelos P, Steward DL et al (2008) Minimally invasive video assisted thyroidectomy: a multiinstitutional North American experience. Arch Otolaryngol Head Neck Surg 134:81–84PubMedCrossRef
17.
go back to reference Minuto MN, Berti P, Miccoli M et al (2012) Minimally invasive video-assisted thyroidectomy: an analysis of results and a revision of indications. Surg Endosc 26:818–822PubMedCrossRef Minuto MN, Berti P, Miccoli M et al (2012) Minimally invasive video-assisted thyroidectomy: an analysis of results and a revision of indications. Surg Endosc 26:818–822PubMedCrossRef
18.
go back to reference Radford PD, Ferguson MS, Magill JC et al (2011) Meta-analysis of minimally invasive video-assisted thyroidectomy. Laryngoscope 121:1675–1681PubMedCrossRef Radford PD, Ferguson MS, Magill JC et al (2011) Meta-analysis of minimally invasive video-assisted thyroidectomy. Laryngoscope 121:1675–1681PubMedCrossRef
19.
go back to reference Byrd JK, Nguyen SA, Ketcham A et al (2010) Minimally invasive video-assisted thyroidectomy versus conventional thyroidectomy: a cost-effective analysis. Otolaryngol Head Neck Surg 143:789–794PubMedCrossRef Byrd JK, Nguyen SA, Ketcham A et al (2010) Minimally invasive video-assisted thyroidectomy versus conventional thyroidectomy: a cost-effective analysis. Otolaryngol Head Neck Surg 143:789–794PubMedCrossRef
20.
go back to reference Miccoli P, Rago R, Massi M et al (2010) Standard versus video-assisted thyroidectomy: objective postoperative pain evaluation. Surg Endosc 24:2415–2417PubMedCrossRef Miccoli P, Rago R, Massi M et al (2010) Standard versus video-assisted thyroidectomy: objective postoperative pain evaluation. Surg Endosc 24:2415–2417PubMedCrossRef
21.
go back to reference Miccoli P, Materazzi G, Berti P (2010) Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits. Curr Opin Otolaryngol Head Neck Surg 18:114–118PubMedCrossRef Miccoli P, Materazzi G, Berti P (2010) Minimally invasive thyroidectomy in the treatment of well differentiated thyroid cancers: indications and limits. Curr Opin Otolaryngol Head Neck Surg 18:114–118PubMedCrossRef
22.
go back to reference Miccoli P, Pinchera A, Materazzi G et al (2009) Surgical treatment of low-and intermediate-risk papillary thyroid cancer with minimally invasive video-assisted thyroidectomy. J Clin Endocrinol Metab 94:1618–1622PubMedCrossRef Miccoli P, Pinchera A, Materazzi G et al (2009) Surgical treatment of low-and intermediate-risk papillary thyroid cancer with minimally invasive video-assisted thyroidectomy. J Clin Endocrinol Metab 94:1618–1622PubMedCrossRef
24.
go back to reference Miccoli P, Materazzi G (2004) Minimally invasive, video-assisted thyroidectomy (MIVAT). Surg Clin North Am 84:735–741PubMedCrossRef Miccoli P, Materazzi G (2004) Minimally invasive, video-assisted thyroidectomy (MIVAT). Surg Clin North Am 84:735–741PubMedCrossRef
25.
go back to reference Miccoli P, Berti P, Raffaelli M et al (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043PubMedCrossRef Miccoli P, Berti P, Raffaelli M et al (2001) Comparison between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043PubMedCrossRef
26.
go back to reference Kang SW, Lee SC, Lee SH et al (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055PubMedCrossRef Kang SW, Lee SC, Lee SH et al (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055PubMedCrossRef
27.
go back to reference Kang SW, Jeong JJ, Nam KH et al (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209:1–7CrossRef Kang SW, Jeong JJ, Nam KH et al (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209:1–7CrossRef
28.
go back to reference Lee J, Chung WY (2013) Robotic thyroidectomy and neck dissection: past present and future. Cancer J 19:151–161PubMedCrossRef Lee J, Chung WY (2013) Robotic thyroidectomy and neck dissection: past present and future. Cancer J 19:151–161PubMedCrossRef
29.
go back to reference Jackson NR, Yao L, Tufano RP et al (2014) Safety of robotic thyroidectomy approaches: meta-analysis and systematic review. Head Neck 36:137–143PubMedCrossRef Jackson NR, Yao L, Tufano RP et al (2014) Safety of robotic thyroidectomy approaches: meta-analysis and systematic review. Head Neck 36:137–143PubMedCrossRef
30.
go back to reference Yi O, Yoon JH, Lee YM et al (2013) Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol 20:1927–1933PubMedCrossRef Yi O, Yoon JH, Lee YM et al (2013) Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol 20:1927–1933PubMedCrossRef
31.
go back to reference Aliyev S, Taskin HE, Agcaoglu O et al (2013) Robotic transaxillary total thyroidectomy through a single axillary incision. Surgery 153:705–710PubMedCrossRef Aliyev S, Taskin HE, Agcaoglu O et al (2013) Robotic transaxillary total thyroidectomy through a single axillary incision. Surgery 153:705–710PubMedCrossRef
32.
go back to reference Chung WY (2012) Pros of robotic transaxillary thyroid surgery: its impact on cancer control and surgical quality. Thyroid 22:986–987PubMedCrossRef Chung WY (2012) Pros of robotic transaxillary thyroid surgery: its impact on cancer control and surgical quality. Thyroid 22:986–987PubMedCrossRef
33.
go back to reference Terris DJ, Singer MC (2012) Robotic facelift thyroidectomy: facilitating remote access surgery. Head Neck 34:746–747PubMedCrossRef Terris DJ, Singer MC (2012) Robotic facelift thyroidectomy: facilitating remote access surgery. Head Neck 34:746–747PubMedCrossRef
34.
go back to reference Broome JT, Pomeroy S, Solorzano CC (2012) Expense of robotic thyroidectomy: a cost analysis at a single institution. Arch Surg 147:1102–1106PubMedCrossRef Broome JT, Pomeroy S, Solorzano CC (2012) Expense of robotic thyroidectomy: a cost analysis at a single institution. Arch Surg 147:1102–1106PubMedCrossRef
35.
go back to reference Inabnet WB 3rd (2012) Robotic thyroidectomy: must we drive a luxury sedan to arrive at our destination safely? Thyroid 22:988–990PubMedCrossRef Inabnet WB 3rd (2012) Robotic thyroidectomy: must we drive a luxury sedan to arrive at our destination safely? Thyroid 22:988–990PubMedCrossRef
36.
go back to reference Cabot JC, Lee CR, Brunaud L et al (2012) Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis. Surgery 152:1016–1024PubMedCrossRef Cabot JC, Lee CR, Brunaud L et al (2012) Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis. Surgery 152:1016–1024PubMedCrossRef
37.
go back to reference Economopoulos KP, Petralias A, Linos E et al (2012) Psychometric evaluation of Patient Scar Assessment Questionnaire following thyroid and parathyroid surgery. Thyroid 22:145–150PubMedCrossRef Economopoulos KP, Petralias A, Linos E et al (2012) Psychometric evaluation of Patient Scar Assessment Questionnaire following thyroid and parathyroid surgery. Thyroid 22:145–150PubMedCrossRef
38.
go back to reference Linos D, Economopoulos KP, Kiriakopoulos A et al (2013) Scar perceptions after thyroid and parathyroid surgery: comparison of minimal and conventional approaches. Surgery 153:400–407PubMedCrossRef Linos D, Economopoulos KP, Kiriakopoulos A et al (2013) Scar perceptions after thyroid and parathyroid surgery: comparison of minimal and conventional approaches. Surgery 153:400–407PubMedCrossRef
39.
go back to reference Sahm M, Schwarz B, Schmidt S et al (2011) Long-term cosmetic result after minimally invasive video-assisted thyroidectomy. Surg Endosc 25:3202–3208PubMedCrossRef Sahm M, Schwarz B, Schmidt S et al (2011) Long-term cosmetic result after minimally invasive video-assisted thyroidectomy. Surg Endosc 25:3202–3208PubMedCrossRef
40.
go back to reference Bellantone R, Lombardi CP, Bossola M et al (2002) Video-assisted vs conventional thyroid lobectomy: a randomized trial. Arch Surg 137:301–304PubMedCrossRef Bellantone R, Lombardi CP, Bossola M et al (2002) Video-assisted vs conventional thyroid lobectomy: a randomized trial. Arch Surg 137:301–304PubMedCrossRef
41.
go back to reference Garratt A, Schmidt L, Mackintosh A et al (2002) Quality of life measurement: bibliographic study of patient assessed health outcome measures (Review). BMJ 324(7351):1417PubMedCentralPubMedCrossRef Garratt A, Schmidt L, Mackintosh A et al (2002) Quality of life measurement: bibliographic study of patient assessed health outcome measures (Review). BMJ 324(7351):1417PubMedCentralPubMedCrossRef
42.
go back to reference Lee J, Nah KY, Kim RM et al (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 24:3186–3194PubMedCrossRef Lee J, Nah KY, Kim RM et al (2010) Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 24:3186–3194PubMedCrossRef
43.
go back to reference Tae K, Kim KY, Yun BR et al (2012) Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc 26:1871–1877PubMedCrossRef Tae K, Kim KY, Yun BR et al (2012) Functional voice and swallowing outcomes after robotic thyroidectomy by a gasless unilateral axillo-breast approach: comparison with open thyroidectomy. Surg Endosc 26:1871–1877PubMedCrossRef
44.
go back to reference Tae K, Ji YB, Jeong JH et al (2011) Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences. Surg Endosc 25:221–228PubMedCrossRef Tae K, Ji YB, Jeong JH et al (2011) Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences. Surg Endosc 25:221–228PubMedCrossRef
45.
go back to reference Perier N (2012) Why I have abandoned robot assisted transaxillary thyroid surgery. Surgery 152:1025–1026CrossRef Perier N (2012) Why I have abandoned robot assisted transaxillary thyroid surgery. Surgery 152:1025–1026CrossRef
46.
go back to reference Duh QY (2011) Robot assisted endoscopic thyroidectomy: has the time come to abandon neck incisions? Ann Surg 253:1067–1068PubMedCrossRef Duh QY (2011) Robot assisted endoscopic thyroidectomy: has the time come to abandon neck incisions? Ann Surg 253:1067–1068PubMedCrossRef
Metadata
Title
Cosmetic Result and Overall Satisfaction after Minimally Invasive Video-assisted Thyroidectomy (MIVAT) versus Robot-assisted Transaxillary Thyroidectomy (RATT): A Prospective Randomized Study
Authors
Gabriele Materazzi
Lorenzo Fregoli
Gabriele Manzini
Angelo Baggiani
Mario Miccoli
Paolo Miccoli
Publication date
01-06-2014
Publisher
Springer US
Published in
World Journal of Surgery / Issue 6/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-014-2483-5

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