Track Recurrence After Robotic Transaxillary Thyroidectomy; A Case Report Highlighting The Importance of Controlled Surgical Indications and Addressing Unprecedented Complications.

Track Recurrence After Robotic Transaxillary Thyroidectomy; A Case Report Highlighting The Importance of Controlled Surgical Indications and Addressing Unprecedented Complications.

Thyroid. 2016 Feb 5;

Authors: Bakkar S, Frustaci G, Papini P, Fregoli L, Matteucci V, Materazzi G, Miccoli P

Abstract
BACKGROUND: Robot-assisted transaxillary thyroid surgery, widely accepted and used in Eastern countries, can be an appealing treatment option for both patients with major concerns regarding a cervical scar, and their surgeons. Patients are offered a scarless neck surgery, while their surgeons are offered improved dexterity and ergonomics compared to remote-access endoscopic thyroid surgery. However, validating any novel surgical procedure for thyroid pathology should be based on evidence regarding its feasibility, radicality and safety compared to the time-honored, safe and effective conventional open thyroidectomy. It should also be evaluated for potential risks that do not have conventional analogues.
PATIENT FINDINGS: We received a patient with surgical tract and cervical nodal recurrence, and distant metastasis following a two-stage robot-assisted surgery, and radioactive iodine ablation therapy for a papillary thyroid carcinoma that was initially regarded a single indeterminate nodule.
SUMMARY: This case emphasizes the importance of thoroughly evaluating the oncological safety of robot-assisted thyroid surgery, and points out the possibility of "malignant seeding along the surgical access" being an untraditional potential complication associated with the procedure.
CONCLUSIONS: While tailoring the surgical strategy undertaken to patients' concerns and desires is important, abiding to fundamental onco-surgical principles is a priority. Furthermore, unconventional complications associated with novel surgical procedures should be properly evaluated and addressed.

PMID: 26850129 [PubMed - as supplied by publisher]

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