Predictive factors for difficult robotic thyroidectomy using the bilateral axillo-breast approach.

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Papillary thyroid carcinoma (PTC) management often involves thyroidectomy.
• The bilateral axillo-breast approach (BABA) is a robotic technique for thyroidectomy.
• Predicting surgical difficulty is crucial for patient outcomes.

Purpose of the Study:

• To identify predictors of difficult robotic thyroidectomy using the BABA approach.
• To analyze factors associated with operative time and complexity in BABA thyroidectomy for PTC.

Main Methods:

• Retrospective analysis of patients with PTC undergoing robotic thyroidectomy with cervical lymph node dissection (July 2008 - June 2013).
• Patients categorized into 'difficult' and 'non-difficult' thyroidectomy groups.
• Clinicopathologic characteristics, surgical outcomes, and postoperative morbidities were compared.

Main Results:

• Male sex was the sole significantly different clinicopathologic factor between groups (p=0.013).
• No significant differences in postoperative complications (hypoparathyroidism, vocal cord palsy, seroma) were observed.
• Male sex independently predicted difficult robotic thyroidectomy (OR=5.379, p=0.043).

Conclusions:

• Male sex is the only identified predictive factor for difficult robotic thyroidectomy via BABA.
• Further research is needed to identify additional factors influencing surgical difficulty.
• Findings can inform surgical planning and patient selection for BABA thyroidectomy.