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Surg Today. 2019 May;49(5):420-426. doi: 10.1007/s00595-018-1748-2. Epub 2019 Jan 2.

The application of subcapsular saline injection during bilateral axillo-breast approach robotic thyroidectomy: a preliminary report.

Author information

1
Department of Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea.
2
Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, South Korea.
3
Department of Surgery, Gachon University College of Medicine, Gil Medical Center, 774, Namdong-daero, Namdong-gu, Incheon, South Korea.
4
Department of Surgery, Seoul National University Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul, South Korea.
5
Department of Surgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, South Korea. juneychoi@snubh.org.

Abstract

PURPOSE:

Saving the parathyroid gland during robotic thyroidectomy is challenging. This study evaluated the application of a novel method, subcapsular saline injection (SCASI), to save the parathyroid gland during bilateral axillo-breast approach (BABA) robotic total thyroidectomy.

METHODS:

Of the 81 included patients operated on from 2014 to 2016, 31 and 50 underwent BABA robotic total thyroidectomy with and without SCASI, respectively. Serum concentrations of parathyroid hormone (PTH), calcium, and ionized calcium were measured at 1 day and 9 months postoperatively. Transient hypoparathyroidism was defined as PTH < 10.0 pg/mL after 1 day and permanent hypoparathyroidism as PTH < 15.0 pg/mL at 9 months.

RESULTS:

There were no significant clinicopathologic differences between the two groups. The rate of transient hypoparathyroidism was significantly lower in the SCASI group than in the non-SCASI group [16.1% (5/31) vs. 44% (22/50), p < 0.01]. However, the rates of permanent hypoparathyroidism [0% (0/31) vs. 4% (2/50), p = 0.699] did not differ significantly.

CONCLUSIONS:

SCASI is a feasible and safe method of saving the parathyroid gland during BABA robotic total thyroidectomy.

KEYWORDS:

Bilateral axillo-breast approach; Parathyroid; Robotic thyroidectomy; SCASI; Subcapsular saline injection

PMID:
30604214
DOI:
10.1007/s00595-018-1748-2
[Indexed for MEDLINE]

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