A prospective case<b>-</b>control study on the influence of Da Vinci Xi robot and endoscopic surgery on voice function in thyroid cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Peigen ¹ , GENG Chengyi ¹ , LUO Jie ¹ , SHEN Meiying ¹ , CHEN Daibo ² , YANG Yinghong ¹ ,  YAN Jing ¹

1. Department of General Surgery, Panzhihua Central Hospital, Panzhihua, Sichuan 617067, P. R. China;
2. Department of Otolaryngology, Panzhihua Central Hospital, Panzhihua, Sichuan 617067, P. R. China;

Corresponding?author：

YAN Jing, Email: 1455819058@qq.com

Keywords：

thyroid neoplasm; voice evaluation; robotic thyroidectomy; endoscopic thyroidectomy

DOI：

10.7507/1007-9424.202307024

Video：

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Objective To compare the effect of robotic thyroidectomy and endoscopic thyroidectomy on the voice function. Methods The clinical data of 181 patients with differentiated thyroid cancer admitted to Panzhihua Central Hospital of Sichuan Province from March 2022 to June 2023 were analyzed retrospectively. According to the operative mode, this patients were divided into two groups: the endoscope group (n=91) and the robot group (n=90). The subjective and objective acoustic indicators were compared between the two groups at 1 day before operation and 1 week, 1 month and 3 months after operation. Results There were no significant difference in voice handicap index (VHI)-10 scores between the two groups at different time points before and after operation (P>0.05). There were no significant difference of VHI-10 scores between preoperative and different postoperative phases in the robot group (P>0.05). The score of VHI-10 at different postoperative phases in the endoscopic group was higher than that at 1 d before operation (P<0.05). The incidence of voice dysfunction (VHI-10 score ≥8) was 1.1% (1/90), 1.1% (1/90) and 0.0% (0/90) in the robot group, 1.1% (1/91) , 2.2% (2/91) and 0.0% (0/91) in the endoscope group at 1 week, 1 month and 3 months after operation respectively, there were no significant difference between the two groups (P>0.05). The fundamental frequency of patients in the endoscopic group was lower than that at 1 d before operation (P<0.05), and there was no significant difference between each phase after operation and at 1 d before operation of fundamental frequency in the robot group (P>0.05). The fundamental frequency of patients in the endoscopic group was lower than that in the robot group at 1 week after operation (P<0.05). The maximum phonation time of each phase after operation in the robot group was not significantly different from that at 1 d before operation (P>0.05). The maximum phonation time of 1 week after operation in the endoscopic group was shorter than that at 1 d before operation (P<0.05) and also shorter than that in the robot group (P<0.05). There were no significant difference in fundamental frequency perturbation, amplitude perturbation, harmonic noise ratio and voice disorder severity index between the two groups at different phases before and after operation (P>0.05). Conclusion Compared with endoscopic thyroidectomy, the voice function of robotic thyroidectomy via bilateral axillary breast approach is better.

Citation： LIU Peigen, GENG Chengyi, LUO Jie, SHEN Meiying, CHEN Daibo, YANG Yinghong, YAN Jing. A prospective case-control study on the influence of Da Vinci Xi robot and endoscopic surgery on voice function in thyroid cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(11): 1353-1358. doi: 10.7507/1007-9424.202307024 Copy

1.	Solis-Pazmino P, Salazar-Vega J, Lincango-Naranjo E, et al. Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador. BMC Cancer, 2021, 21(1): 42. doi: 10.1186/s12885-020-07735-y.
2.	楊映弘, 藺原, 吳艷軍, 等. 經乳房途徑腔鏡甲狀腺切除術27例報告. 中國普外基礎與臨床雜志, 2005, 12(3): 299-300.
3.	楊映弘, 吳艷軍, 藺原, 等. 腔鏡與傳統開放甲狀腺切除術的比較. 中國微創外科雜志, 2006, 6(2): 119-120.
4.	盧曼, 孫金中, 孫圣榮. 腔鏡甲狀腺手術發展與選擇. 中國普外基礎與臨床雜志, 2022, 29(6): 816-822.
5.	Pavlidis ET, Psarras KK, Symeonidis NG, et al. Robot-assisted thyroidectomy versus open thyroidectomy in the treatment of well differentiated thyroid carcinoma. JSLS. 2021, 25(3): e2021.00032. doi: 10.4293/JSLS.2021.00032.
6.	曾令娟, 馬靜, 范林軍, 等. 達芬奇機器人甲狀腺癌根治術后引流管拔除時機的臨床對照研究. 中國普外基礎與臨床雜志, 2020, 27(4): 460-463.
7.	賀青卿, 朱見, 范子義, 等. 達芬奇機器人腋乳徑路與傳統開放手術治療甲狀腺微小癌的對照研究. 中華外科雜志, 2016, 54(1): 51-55.
8.	王猛, 鄭魯明, 周鵬, 等. 腔鏡與機器人甲狀腺手術治療甲狀腺微小乳頭狀癌的對比研究. 腫瘤預防與治療, 2021, 34(12): 1117-1122.
9.	任婷婷, 蘭德, 魏雪梅. 甲狀腺切除患者手術前后嗓音功能評估. 中國耳鼻咽喉顱底外科雜志, 2020, 26(4): 369-372.
10.	中國醫師協會外科醫師分會甲狀腺外科醫師委員會, 中國研究型醫院學會甲狀腺疾病專業委員會, 海峽兩岸醫藥衛生交流協會海西甲狀腺微創美容外科專家委員會, 等. 經胸前入路腔鏡甲狀腺手術專家共識(2017版). 中國實用外科雜志, 2017, 37(12): 1369-1373.
11.	中國醫師協會外科醫師分會甲狀腺外科醫師委員會, 中國研究型醫院學會甲狀腺疾病專業委員會. 機器人手術系統輔助甲狀腺和甲狀旁腺手術專家共識. 中國實用外科雜志, 2016, 36(11): 1165-1170.
12.	徐文, 李紅艷, 胡蓉, 等. 嗓音障礙指數量表中文版信度和效度評價. 中華耳鼻咽喉頭頸外科雜志, 2008, 43(9): 670-675.
13.	Behlau M, Madazio G, Moreti F, et al. Efficiency and cutoff values of self-assessment instruments on the impact of a voice problem. J Voice, 2016, 30(4): 506.
14.	中華人民共和國國家衛生健康委員會醫政醫管局. 甲狀腺癌診療指南(2022年版). 中國實用外科雜志, 2022, 42(12): 1343-1357, 1363.
15.	Van Lierde K, D’haeseleer E, Wuyts FL, et al. Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: an objective multiparameter approach. Laryngoscope, 2010, 120(2): 338-345.
16.	Tae K, Ji YB, Song CM, et al. Safety and efficacy of transoral robotic and endoscopic thyroidectomy: the first 100 cases. Head Neck, 2020, 42(2): 321-329.
17.	劉思維, 邵駿. 嗓音聲學分析方法的研究現狀. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(12): 966-970, 976.
18.	Choi JY, Bae IE, Kim HS, et al. Comparative study of bilateral axillo-breast approach endoscopic and robotic thyroidectomy: propensity score matching analysis of large multi-institutional data. Ann Surg Treat Res, 2020, 98(6): 307-314.
19.	Chung EJ, Park MW, Cho JG, et al. A prospective 1-year comparative study of endoscopic thyroidectomy via a retroauricular approach versus conventional open thyroidectomy at a single institution. Ann Surg Oncol, 2015, 22(9): 3014-3021.
20.	Lee DY, Lee KJ, Han WG, et al. Comparison of transaxillary approach, retroauricular approach, and conventional open hemithyroidectomy: a prospective study at single institution. Surgery, 2016, 159(2): 524-531.
21.	Van Damme S, Cosyns M, Deman S, et al. The effectiveness of pitch-raising surgery in male-to-female transsexuals: a systematic review. J Voice, 2017, 31(2): 244.

1. Solis-Pazmino P, Salazar-Vega J, Lincango-Naranjo E, et al. Thyroid cancer overdiagnosis and overtreatment: a cross- sectional study at a thyroid cancer referral center in Ecuador. BMC Cancer, 2021, 21(1): 42. doi: 10.1186/s12885-020-07735-y.
2. 楊映弘, 藺原, 吳艷軍, 等. 經乳房途徑腔鏡甲狀腺切除術27例報告. 中國普外基礎與臨床雜志, 2005, 12(3): 299-300.
3. 楊映弘, 吳艷軍, 藺原, 等. 腔鏡與傳統開放甲狀腺切除術的比較. 中國微創外科雜志, 2006, 6(2): 119-120.
4. 盧曼, 孫金中, 孫圣榮. 腔鏡甲狀腺手術發展與選擇. 中國普外基礎與臨床雜志, 2022, 29(6): 816-822.
5. Pavlidis ET, Psarras KK, Symeonidis NG, et al. Robot-assisted thyroidectomy versus open thyroidectomy in the treatment of well differentiated thyroid carcinoma. JSLS. 2021, 25(3): e2021.00032. doi: 10.4293/JSLS.2021.00032.
6. 曾令娟, 馬靜, 范林軍, 等. 達芬奇機器人甲狀腺癌根治術后引流管拔除時機的臨床對照研究. 中國普外基礎與臨床雜志, 2020, 27(4): 460-463.
7. 賀青卿, 朱見, 范子義, 等. 達芬奇機器人腋乳徑路與傳統開放手術治療甲狀腺微小癌的對照研究. 中華外科雜志, 2016, 54(1): 51-55.
8. 王猛, 鄭魯明, 周鵬, 等. 腔鏡與機器人甲狀腺手術治療甲狀腺微小乳頭狀癌的對比研究. 腫瘤預防與治療, 2021, 34(12): 1117-1122.
9. 任婷婷, 蘭德, 魏雪梅. 甲狀腺切除患者手術前后嗓音功能評估. 中國耳鼻咽喉顱底外科雜志, 2020, 26(4): 369-372.
10. 中國醫師協會外科醫師分會甲狀腺外科醫師委員會, 中國研究型醫院學會甲狀腺疾病專業委員會, 海峽兩岸醫藥衛生交流協會海西甲狀腺微創美容外科專家委員會, 等. 經胸前入路腔鏡甲狀腺手術專家共識(2017版). 中國實用外科雜志, 2017, 37(12): 1369-1373.
11. 中國醫師協會外科醫師分會甲狀腺外科醫師委員會, 中國研究型醫院學會甲狀腺疾病專業委員會. 機器人手術系統輔助甲狀腺和甲狀旁腺手術專家共識. 中國實用外科雜志, 2016, 36(11): 1165-1170.
12. 徐文, 李紅艷, 胡蓉, 等. 嗓音障礙指數量表中文版信度和效度評價. 中華耳鼻咽喉頭頸外科雜志, 2008, 43(9): 670-675.
13. Behlau M, Madazio G, Moreti F, et al. Efficiency and cutoff values of self-assessment instruments on the impact of a voice problem. J Voice, 2016, 30(4): 506.
14. 中華人民共和國國家衛生健康委員會醫政醫管局. 甲狀腺癌診療指南(2022年版). 中國實用外科雜志, 2022, 42(12): 1343-1357, 1363.
15. Van Lierde K, D’haeseleer E, Wuyts FL, et al. Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: an objective multiparameter approach. Laryngoscope, 2010, 120(2): 338-345.
16. Tae K, Ji YB, Song CM, et al. Safety and efficacy of transoral robotic and endoscopic thyroidectomy: the first 100 cases. Head Neck, 2020, 42(2): 321-329.
17. 劉思維, 邵駿. 嗓音聲學分析方法的研究現狀. 臨床耳鼻咽喉頭頸外科雜志, 2022, 36(12): 966-970, 976.
18. Choi JY, Bae IE, Kim HS, et al. Comparative study of bilateral axillo-breast approach endoscopic and robotic thyroidectomy: propensity score matching analysis of large multi-institutional data. Ann Surg Treat Res, 2020, 98(6): 307-314.
19. Chung EJ, Park MW, Cho JG, et al. A prospective 1-year comparative study of endoscopic thyroidectomy via a retroauricular approach versus conventional open thyroidectomy at a single institution. Ann Surg Oncol, 2015, 22(9): 3014-3021.
20. Lee DY, Lee KJ, Han WG, et al. Comparison of transaxillary approach, retroauricular approach, and conventional open hemithyroidectomy: a prospective study at single institution. Surgery, 2016, 159(2): 524-531.
21. Van Damme S, Cosyns M, Deman S, et al. The effectiveness of pitch-raising surgery in male-to-female transsexuals: a systematic review. J Voice, 2017, 31(2): 244.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

A prospective case-control study on the influence of Da Vinci Xi robot and endoscopic surgery on voice function in thyroid cancer

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