Comparative surgical outcomes of transoral endoscopic and robotic thyroidectomy for thyroid carcinoma: a propensity score-matched analysis,Surgical Endoscopy

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Comparative surgical outcomes of transoral endoscopic and robotic thyroidectomy for thyroid carcinoma: a propensity score-matched analysis
Surgical Endoscopy ( IF 2.4 ) Pub Date : 2022-09-21 , DOI: 10.1007/s00464-022-09636-6
Min Jung Lee ₁ , Moon Young Oh ₁ , Jung-Man Lee ₂ , Jiyu Sun ₃ , Young Jun Chai _{4,

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Affiliation

Background

Surgical outcomes of patients with thyroid carcinoma who underwent transoral endoscopic thyroidectomy vestibular approach (TOETVA) versus transoral robotic thyroidectomy (TORT) were compared.

Methods

Patients who underwent TOETVA or TORT between July 2016 and February 2022 were retrospectively analyzed. TOETVA and TORT groups were propensity score-matched (1:1) based on age, sex, body mass index, surgical extent, tumor size, and presence of thyroiditis.

Results

A total of 185 patients underwent transoral thyroidectomy (142 TOETVA and 43 TORT). Final diagnoses consisted of 135 papillary and seven follicular thyroid carcinomas in the TOETVA group and 43 papillary thyroid carcinomas in the TORT group (p = 0.138). Mean operative time was shorter for the TOETVA group than the TORT group (106.3 vs. 158.9 min, p < 0.001), whereas mean hospital stay was longer for the TOETVA group than the TORT group (2.2 vs. 1.9 days, p = 0.031). After 1:1 propensity score matching, each group included 43 patients. Mean operative time was shorter in the TOETVA group than the TORT group (106.2 vs. 158.9 min, p < 0.001), whereas mean hospital stay was longer in the TOETVA group (2.3 vs. 1.9 days, p = 0.031). There was no significant difference in vocal cord palsy incidences between the groups (one transient, one permanent in the TOETVA group vs. none in the TORT group, p = 0.359). The learning curve was 71 cases for TOETVA and 25 cases for TORT.

Conclusion

TOETVA had shorter mean operative time, and TORT had shorter learning curve and shorter mean hospital stay. Surgeons should be familiar with the advantages and disadvantages of each procedure.

中文翻译：

经口内镜和机器人甲状腺切除术治疗甲状腺癌的比较手术结果：倾向评分匹配分析

背景

比较了接受经口内镜前庭甲状腺切除术 (TOETVA) 与经口机器人甲状腺切除术 (TORT) 的甲状腺癌患者的手术结果。

方法

回顾性分析了 2016 年 7 月至 2022 年 2 月期间接受 TOETVA 或 TORT 的患者。TOETVA 和 TORT 组根据年龄、性别、体重指数、手术范围、肿瘤大小和是否存在甲状腺炎进行倾向评分匹配 (1:1)。

结果

共有 185 名患者接受了经口甲状腺切除术（142 名 TOETVA 和 43 名 TORT）。最终诊断包括 TOETVA 组中的 135 例乳头状甲状腺癌和 7 例滤泡性甲状腺癌以及 TORT 组中的 43 例乳头状甲状腺癌 ( p = 0.138)。TOETVA 组的平均手术时间短于 TORT 组（106.3 对 158.9 分钟，p < 0.001），而 TOETVA 组的平均住院时间长于 TORT 组（2.2 对 1.9 天，p = 0.031） . 经过 1:1 倾向评分匹配后，每组包括 43 名患者。TOETVA 组的平均手术时间短于 TORT 组（106.2 对 158.9 分钟，p < 0.001），而 TOETVA 组的平均住院时间更长（2.3 对 1.9 天，p = 0.031）。两组间声带麻痹的发生率没有显着差异（TOETVA 组中有一种是短暂性的，一种是永久性的，而 TORT 组中没有，p = 0.359）。TOETVA 的学习曲线为 71 例，TORT 为 25 例。