Preliminary Study on Safety of Robotic or Endoscopic Thyroidectomy via Bilateral Axillo-breast Approach (BABA) without Drainage Procedure: Multicenter Trial

So Hyang Moon; Young San Jeon; Wan Wook Kim; Su Hwan Kang; Young Ju Jeong; Jung Eun Choi; Jihyoung Cho

doi:10.16956/kjes.2015.15.2.47

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Moon, Jeon, Kim, Kang, Jeong, Choi, and Cho: Preliminary Study on Safety of Robotic or Endoscopic Thyroidectomy via Bilateral Axillo-breast Approach (BABA) without Drainage Procedure: Multicenter Trial

Original Article

Korean Journal of Endocrine Surgery 2015; 15(2): 47-51.

Published online: 24 June 2015

DOI: https://doi.org/10.16956/kjes.2015.15.2.47

Preliminary Study on Safety of Robotic or Endoscopic Thyroidectomy via Bilateral Axillo-breast Approach (BABA) without Drainage Procedure: Multicenter Trial

So Hyang Moon, Young San Jeon¹, Wan Wook Kim², Su Hwan Kang³, Young Ju Jeong⁴, Jung Eun Choi³, Jihyoung Cho

Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.

¹Goo Hospital, Daegu, Korea.

²Kyungpook National University School of Medicine, Daegu, Korea.

³Yeungnam University College of Medicine, Daegu, Korea.

⁴Catholic University of Daegu College of Medicine, Daegu, Korea.

Correspondence: Jihyoung Cho. Department of Surgery, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 700-712, Korea. Tel: +82-53-250-7063, Fax: +82-53-250-7322, chojh0404@dsmc.or.kr

Received 5 March 2015 Revised 15 April 2015 Accepted 14 May 2015

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The aim of this study was to evaluate the safety of robotic or endoscopic thyroidectomy via bilateral axillo-breast approach (BABA) without a drainage procedure.

Methods

A total of 64 patients who underwent robotic or endoscopic thyroidectomy via BABA without a close suction drain between February and March 2012 were enrolled. We checked postoperative symptoms or signs including change of vital signs, dyspnea, swelling or fluctuation of anterior chest and neck and compression symptoms at 1, 6, 24, and 48 hours and 1 month after surgery. Postoperative ultrasonography was performed in patients with at least one or more postoperative symptoms or signs in order to confirm hematoma or fluid collection.

Results

None of the enrolled patients had dyspnea or change of vital signs. Two of 64 patients had swelling, 1 of 64 patients had fluctuation on the anterior chest, and 1 of 64 patients had compression symptoms. Fluid collection was confirmed in 2 of 4 of the above mentioned patients and the collected fluid was aspirated. The amounts of aspirated fluid were 25 mL and 8 mL. Thereafter, the follow up ultrasonography showed no more fluid collection in all patients. In addition, we rechecked the above mentioned symptoms or signs at 1 month after surgery; none of the enrolled patients had symptoms or signs.

Conclusion

Robotic or endoscopic thyroidectomy via BABA without a closed suction drain shows no serious seroma or hematoma collection. Therefore, we expect that robotic or endoscopic thyroidectomy via BABA without a closed suction drain can reduce the pain, discomfort or longer hospital stay as a result of closed suction drain using this method.

Keywords: Drain, Endoscopic thyroidectomy, Robotic thyroidectomy, Bilateral axillo-breast approach

Figures and Tables

Fig. 1

Case 1. (A) In USG, there was minimal fluid collection on sterna notch. (B) After 8 mL fluid aspiration, there was no more fluid collection.

Fig. 2

Case 2. (A, B) In USG, there was minimal fluid collection above SCM. (C) After 25 mL fluid aspiration, there was no more fluid collection.

Table 1

Clinical characteristics of the patients

Table 2

Incidence and management of abnormal sign and symptom

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