Ann Surg Treat Res.  2016 May;90(5):239-245. 10.4174/astr.2016.90.5.239.

A comparative study of postoperative pain for open thyroidectomy versus bilateral axillo-breast approach robotic thyroidectomy using a self-reporting application for iPad

• Chai YJ
• Song J
• Kang J
• Woo JW
• Song RY
• Kwon H
• Kim SJ
• Choi JY
• Lee KE

• KMID: 2163062
• DOI: http://doi.org/10.4174/astr.2016.90.5.239

Abstract

PURPOSE
Postoperative pain for robotic thyroid surgeries including bilateral axillo-breast approach (BABA) has not been well studied. In this study, we have developed a self-reporting application (SRA) for iPad and prospectively collected pain scores from open thyroidectomy (OT) and BABA robotic thyroidectomy (RT) patients.
METHODS
Female patients who underwent total thyroidectomy for papillary thyroid carcinoma were included. Patients recorded pain scores for throat, anterior neck, posterior neck, chest, and back on postoperative days 1, 2, and 3. Once discharged, on postoperative day 14, a survey was also conducted on satisfaction of SRA and cosmesis.
RESULTS
A total of 54 patients were enrolled (27 BABA RT and 27 OT). There were no significant differences between the 2 groups in clinicopathological characteristics and postoperative complication rates. Postoperative pain scores at days 1, 2, 3, and 14 were not significantly different between the groups for throat, anterior neck, posterior neck, or back. Postoperative analgesic requirements were similar between the 2 groups. Wound satisfaction scores were significantly higher in the BABA RT group (BABA RT 7.4 vs. OT 5.7; P = 0.016). Satisfaction scores for the usefulness of SRA were above 7.2 for all four questionnaire items on the 10-point scale.
CONCLUSION
Postoperative pain for BABA RT is equivalent to OT but offers greater cosmetic satisfaction for patients. A mobile device application such as SRA may facilitate proper assessment and management of pain in postoperative patients.

Keyword

Robotic thyroidectomy; Bilateral axillo-breast approach; BABA; Postoperative pain; iPAD

MeSH Terms

Female
Humans
Neck
Pain, Postoperative*
Pharynx
Postoperative Complications
Prospective Studies
Thorax
Thyroid Gland
Thyroid Neoplasms
Thyroidectomy*
Wounds and Injuries

Figure

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  Fig. 1 Location of 4 incisions and flap dissection area (in red) for bilateral axillo-breast approach robotic thyroidectomy.

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  Fig. 2 Patient using self-reporting application.

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  Fig. 3 Pain assessment questionnaire.

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