Background

Various approaches for thyroid surgery became possible with the use of robotic systems. Transoral robotic thyroidectomy (TORT) is one of the newest approaches and draws attention because of its cosmetic excellence. In this study, we compared the surgical outcomes of TORT and conventional open thyroidectomy (OT).

Methods

We retrospectively reviewed and compared the medical records of consecutive patients who underwent TORT or OT for thyroid carcinoma from March 2009 to January 2018. Propensity score matching using 10 clinico-pathologic factors was used to generate two matched cohorts, each composed of 186 patients.

Results

The study included 372 patients who underwent TORT (n = 186) or OT (n = 186). Mean age, tumor size, and gender were not different between both groups. The two groups showed similar surgical outcomes, except for a longer operative time for TORT. There was one patient with immediate postoperative bleeding in the TORT group. The patient underwent re-operation for hemostasis with endoscopic approach. In the OT group, one patient had wound seroma, which was treated by several rounds of needle aspiration without infection. Vocal cord palsy was present in one patient in the TORT group, which was recovered in 3 months.

Conclusions

TORT could be performed safely and had comparable surgical outcomes with OT in the selected patients. TORT may be a suitable operative alternative for patients who do not want to leave scars on the neck.

中文翻译：

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经口机器人甲状腺切除术与常规开放性甲状腺切除术：使用倾向评分匹配对手术结果进行比较分析。

背景

通过使用机器人系统，各种甲状腺手术方法成为可能。经口机器人甲状腺切除术（TORT）是最新的方法之一，由于其出色的美容效果而引起了人们的关注。在这项研究中，我们比较了TORT和常规开放性甲状腺切除术（OT）的手术效果。

方法

我们回顾性分析并比较了2009年3月至2018年1月连续接受TORT或OT甲状腺癌治疗的患者的病历。使用10个临床病理因素进行的倾向得分匹配产生了两个匹配的队列，每个队列由186例患者组成。

结果

该研究包括372名接受TORT（n  = 186）或OT（n  = 186）的患者。两组之间的平均年龄，肿瘤大小和性别无差异。两组显示相似的手术结果，不同的是TORT手术时间更长。TORT组中有1例患者术后立即出血。病人通过内窥镜手术再次止血。在OT组中，一名患者患有伤口血清肿，可通过多轮针吸术治疗，无感染。TORT组的一名患者出现了声带麻痹，并在3个月内康复。

结论

在选定的患者中，可以安全地进行TORT并获得与OT相当的手术结果。对于不想在颈部留下疤痕的患者，TORT可能是一种合适的手术选择。