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Cited 8 time in webofscience Cited 8 time in scopus
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Transoral robotic thyroidectomy versus transoral endoscopic thyroidectomy: a propensity-score-matched analysis of surgical outcomes

Authors
Chen, Yu-HsienKim, Hoon-YubAnuwong, AngkoonHuang, Ting-ShuoDuh, Quan-Yang
Issue Date
Nov-2021
Publisher
Springer Verlag
Keywords
TOETVA; TORT; Transoral endoscopic thyroidectomy; Transoral robotic thyroidectomy
Citation
Surgical Endoscopy, v.35, no.11, pp.6179 - 6189
Indexed
SCIE
SCOPUS
Journal Title
Surgical Endoscopy
Volume
35
Number
11
Start Page
6179
End Page
6189
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/49183
DOI
10.1007/s00464-020-08114-1
ISSN
0930-2794
Abstract
Background Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been shown to be safe and has similar outcomes as open thyroidectomy for selected patients. It is not clear if transoral robotic thyroidectomy (TORT) may extend transoral endoscopic thyroidectomy to more complex thyroid operations. The study aimed to compare the safety and outcomes of TORT with those of TOETVA. Methods We retrospectively reviewed all patients who had TORT and TOETVA performed by a single surgeon from June 2017 to May 2019. Intrathoracic goiter and combined operations were excluded. Surgical outcomes were compared after propensity score matching. Learning curves, as measured by operating time, were evaluated. Results A total of 150 patients underwent 154 transoral (55 TORT and 99 TOETVA) thyroidectomy. Of the 154 operations, 28 (18.2%) were bilateral total thyroidectomy and 126 (81.8%) were unilateral thyroid lobectomy. After propensity score matching, we found a longer operative time (median [interquartile range]) for TORT (n = 53) than for the TOETVA (308 [284–388] vs 228 [201–267] min, P < 0.001). Blood loss and visual analog scale scores for pain were not significantly different between the two groups. Central neck lymph node dissection was performed more frequent in the TORT group (28 of 53 [52.8%] vs 10 of 53 [18.9%], P = 0.001), and when performed, the numbers of total and positive lymph nodes did not differ significantly between the two groups. The rates of hypoparathyroidism and recurrent laryngeal nerve injury did not differ significantly between the two groups. There was no conversion to open thyroidectomy, mental nerve injury, or surgical site infection. The learning curve for TORT was 25 cases, but no obvious learning curve was observed for TOETVA. Conclusions TORT requires a longer operative time, but is as safe as TOETVA and may be useful for more complex thyroid operations.
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