Comparative analysis between SPRA and BABA thyroid surgery

초록

Background:?With the advent of da Vinci SP, surgical methods using da Vinci SP are becoming popular in thyroid surgery. We had reported a new surgical method named SPRA (Single Port Robotic Areolar approach) thyroid surgery, that eliminates the axillary approach from the previous BABA (Bilateral Axillary Breast Approach). In this study, we aim to report a comparative analysis of SPRA and BABA performed over the last 1 year. Methods:?We retrospectively analyzed data on SPRA and BABA surgeries performed at our hospital for one year from December 2022 to December 2023. All surgeries were performed by a single endocrine surgeon. Results:?During the study period, 111 SPRA and 159 BABA surgeries were performed. SPRA was overwhelmingly performed on women (1 man vs 110 women), and BMI was lower in SPRA (23.63 ± 3.49 versus 25.71 ± 4.39, p<0.001). Proportion of total thyroidectomy was significantly higher in BABA, and MRND were only performed in BABA method. Time for flap creation before robot docking was significantly shorter in SPRA (12.08 ± 3.99 vs 18.34 ± 5.84 min, p<0.001). Postoperative drain amount was also significantly low in SPRA (53.87 ± 35.45 vs 81.74 ± 30.26 ml, p<0.001). Hospital stay days after surgery were also significantly shorter in SPRA (3.04 ± 0.48 versus 3.36 ± 0.73 days, p<0.001). Thyroglobulin level after total thyroidectomy (0.06 ± 0.13 vs 0.45 ± 0.78, p=0.002), and stimulated Tg level before the RAI (1.03 ± 0.74 vs 5.01 ± 13.63, p=0.046) were also significantly lower in SPRA group. There was no significant difference between the two groups according to postoperative complications, including vocal cord palsy, hypoparathyroidism, etc. Conclusion:?Based on our experience, we suggest that SPRA is a less invasive surgical method compared to BABA. As we are attempting to expand the scope of surgery to areas such as MRND, more data analysis will be analyzed in the future.