Transoral robotic thyroidectomy vs. Open thyroidectomy for thyroid cancer: A propensity Score-Matched analysis

Area of Science:

• Head and Neck Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Transoral robotic thyroidectomy (TORT) provides a minimally invasive approach with potential cosmetic benefits.
• Comparative studies are needed to validate TORT against traditional open thyroidectomy (OT).

Purpose of the Study:

• To compare the clinical and patient-reported outcomes of transoral robotic thyroidectomy (TORT) versus open thyroidectomy (OT) for thyroid carcinoma.
• To evaluate differences in pain, voice function, scar satisfaction, and complication rates between the two surgical approaches.

Main Methods:

• A propensity score-matched analysis of 322 adult patients with thyroid carcinoma who underwent either TORT or OT.
• Assessment of clinical outcomes including operative duration, costs, hospitalization, and transient hypoparathyroidism.
• Evaluation of patient-reported outcomes using the Numerical Rating Scale (NRS) for pain, Voice Handicap Index-10 (VHI-10), and Scar Assessment Questionnaire-Cosmetic (SAQCO).

Main Results:

• TORT was associated with significantly higher operative costs and longer operative duration compared to OT.
• The TORT group experienced shorter postoperative hospitalization and a lower incidence of transient hypoparathyroidism.
• Patient-reported outcomes favored TORT, with significantly lower pain scores (NRS), improved voice function (VHI-10), and higher scar satisfaction (SAQCO).

Conclusions:

• Transoral robotic thyroidectomy (TORT) achieves non-inferior perioperative outcomes compared to open thyroidectomy (OT).
• TORT offers superior cosmetic results and reduced hospitalization duration, alongside improved patient-reported outcomes.
• The advantages of TORT must be weighed against its significantly higher costs and longer operative times.