Search

Developments in technology have led to a rapid progress in robotic endocrine surgery applications. With the advent of minimally invasive techniques in thyroid surgery, robot-assisted transaxillary thyroid surgery (RATS) has emerged as one of the most promising approaches. Its main advantages are improved cosmetic outcome, avoiding cervical incisions, thereby increasing patient satisfaction, and improved visualization, arms articulations, and precision, resulting in fewer surgical complications. The main disadvantages are potential new injuries to the brachial plexus, esophagus, and trachea, longer operative time, and increased cost compared to conventional thyroidectomy. In skilled hands, RATS is a safe alternative to conservative thyroidectomy and should be presented to patients with aesthetic concerns. As with any new emerging technique, careful patient selection is crucial, and further evidence must be sought to confirm its indications over time.

Free radicals such as reactive oxygen species (ROS) and reactive nitrogen species (RNS), which induce oxidative and nitrative stress, are main contributors to oral carcinogenesis. The RNS (nitrosamines: nitrates, NO3, and nitrites, NO2) are also produced by the reaction of ROS and other free radicals with nitric oxide (NO) and are therefore in equilibrium with it.Whole saliva was collected from a group of 25 consenting oral squamous cell carcinoma (OSCC) patients and from a control group of 25 healthy age‐ and gender‐matched individuals. General and specific salivary antioxidant components, salivary nitrosamines, and oxidatively damaged salivary DNA and proteins were measured.The findings showed that oxidative and nitrative stress altered the salivary composition in OSCC patients. Analyzed salivary RNS were substantially higher (NO, 60%; NO2, 190%; NO3, 93%), whereas all salivary antioxidants were substantially reduced. The 8‐hydroxy‐deoxyguanosine (8‐OHdG) marker (a widely used indicator of DNA oxidation) increased by 65% and the salivary carbonylation level was significantly higher.The increase in ROS and RNS may have been the event that led to the consumption and reduction of salivary antioxidant systems, thus explaining the oxidative damage to the DNA and proteins, and possibly the promotion of OSCC. The oxidized proteins and DNA found in the saliva of the cancer patients seems to be the first demonstration of a direct link between salivary free radicals, antioxidants, and OSCC. This may be important for better understanding the pathogenesis of the disease and may contribute to its diagnosis and treatment. Cancer 2007. © 2006 American Cancer Society. [ABSTRACT FROM AUTHOR]