Re-do Operation Using a Robotic System due to Locoregional Recurrence after Initial Thyroidectomy for Thyroid Cancer

Area of Science:

• Surgical Oncology
• Robotic Surgery
• Endocrinology

Background:

• Locoregional recurrent thyroid cancer often necessitates re-operation.
• Re-do thyroid surgery presents unique surgical challenges due to scar tissue and altered anatomy.
• Minimally invasive techniques are being explored to improve outcomes and reduce morbidity in re-do thyroid surgery.

Purpose of the Study:

• To evaluate the feasibility and outcomes of robotic-assisted re-do surgery for locoregional recurrent thyroid cancer.
• To assess the safety, efficacy, and cosmetic advantages of the trans-axillary robotic approach in this patient population.

Main Methods:

• A retrospective analysis of 65 patients who underwent re-do robotic surgery for recurrent papillary thyroid carcinoma via a trans-axillary approach.
• Procedures included completion total thyroidectomy (CTT), modified radical neck dissection (mRND), or both.
• Data collected included operative times, complication rates, oncologic outcomes, and patient satisfaction.

Main Results:

• The study included completion total thyroidectomy (CTT) in 26 cases, CTT with modified radical neck node dissection (mRND) in 16, and mRND in 23.
• Transient hypocalcemia occurred in 26.2% of patients, permanent hypocalcemia in 4.6%, and one case of recurrent laryngeal nerve (RLN) injury.
• One patient experienced structural recurrence during a median follow-up of 50.7 months, indicating favorable oncologic control.

Conclusions:

• Re-do robotic surgery using the trans-axillary approach is a viable alternative for managing locoregional recurrent thyroid cancer.
• This technique offers comparable oncologic outcomes and morbidity to conventional methods, with the added benefit of superior cosmetic results.
• Robotic re-do surgery enhances patient satisfaction without compromising safety or efficacy in recurrent thyroid cancer management.