양측 액와유륜부 접근법을 이용한 무배액관 로봇 또는 내시경하 갑상선 절제술의 안정성에 대한 예비연구

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

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.