Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
Surg Endosc. 2021 Jun;35(6):2855-2861. doi: 10.1007/s00464-020-07721-2. Epub 2020 Jun 15.
There is an increased use of endoscopic thyroidectomy (ET), including robotic-assisted thyroidectomy (RT), to avoid postoperative scars on the anterior neck. The objective of this study was to compare the surgical and oncologic outcomes between ET and conventional open thyroidectomy (COT) for differentiated thyroid carcinoma (DTC).
We reviewed 4129 patients with DTC who underwent thyroid lobectomy at Seoul St. Mary's Hospital (Seoul, Korea) from January 2009 to December 2014. Patients were categorized according to the type of surgery and statistically compared using propensity score matching analysis.
The mean operation time was significantly longer in the ET group than in the OT group (101.2 ± 26.2 min vs. 86.4 ± 27.0 min, p < 0.001). The number of harvested lymph nodes was significantly lower in the ET group than in the OT group (5.5 ± 4.2 vs. 8.3 ± 6.2, p < 0.001). There was no significant difference in the recurrence rate between the two groups (p = 0.879). Kaplan-Meier analysis revealed no significant difference in the disease-free survival after propensity score matching (p = 0.811). The mean follow-up duration was 90.4 ± 21.0 months.
Transaxillary ET including RT for DTC is a safe and feasible alternative to COT with a cosmetically desirable outcome. Further studies are required to confirm our results.
为避免颈部前方术后疤痕，内镜甲状腺切除术（ET），包括机器人辅助甲状腺切除术（RT）的应用逐渐增多。本研究旨在比较内镜甲状腺切除术与传统开放式甲状腺切除术（COT）治疗分化型甲状腺癌（DTC）的手术和肿瘤学结果。
我们回顾了 2009 年 1 月至 2014 年 12 月期间在首尔圣玛丽医院（韩国首尔）接受甲状腺叶切除术的 4129 例 DTC 患者。根据手术类型对患者进行分类，并使用倾向评分匹配分析进行统计学比较。
ET 组的平均手术时间明显长于 OT 组（101.2±26.2 分钟比 86.4±27.0 分钟，p<0.001）。ET 组的淋巴结检出数明显少于 OT 组（5.5±4.2 个比 8.3±6.2 个，p<0.001）。两组的复发率无显著差异（p=0.879）。倾向评分匹配后的 Kaplan-Meier 分析显示无显著差异（p=0.811）。平均随访时间为 90.4±21.0 个月。
经腋入路 ET 包括 RT 治疗 DTC 是一种安全可行的替代 COT 的方法，具有美容效果。需要进一步的研究来证实我们的结果。
