Jinzhou Medical University, Jinzhou, Liaoning, 121000, China.
Department of Thyroid and Breast Surgery, the 960th Hospital of People's Liberation Army, No.25, Shifan Road, Tianqiao District, Jinan, 250031, China.
BMC Surg. 2023 Nov 8;23(1):338. doi: 10.1186/s12893-023-02250-w.
Robot-assisted and endoscopic thyroidectomy are superior to conventional open thyroidectomy in improving cosmetic outcomes and postoperative quality of life. The procedure of these thyroidectomies was similar in terms of surgical view, feasibility, and invasiveness. However, it remains uncertain whether the robotic-assisted bilateral axilla-breast approach (BABA) was superior to the endoscopic bilateral areolar approach (BAA) thyroidectomy. This study aimed to investigate the clinical benefit of these two surgical procedures to evaluate the difference between these two surgical procedures by comparing the pathological and surgical outcomes of endoscopic BAA and robotic-assisted BABA thyroidectomy in differentiated thyroid carcinoma.
From November 2018 to September 2021, 278 patients with differentiated thyroid carcinoma underwent BABA robot-assisted, and 49 underwent BAA approach endoscopic thyroidectomy. Of these patients, we analyzed 42 and 135 patients of endoscopic and robotic matched pairs using 1:4 propensity score matching and retrospective cohort study methods. These two groups were retrospectively compared by surgical outcomes, clinicopathological characteristics, and postoperative complications.
The mean operation time was significantly longer in the EG than in the RG (p < 0.001), The number of retrieved lymph nodes was significantly lower in the ET group than in the RT group (p < 0.001). The mean maximum diameter of the thyroid was more expansive in the EG than in the RG (p = 0.04). There were no significant differences in the total drainage amount and drain insertion days between the two groups (p = 0.241, p = 0.316, respectively). Both groups showed that cosmetic satisfaction (p = 0.837) and pain score (p = 0.077) were similar. There were no significant differences in complication frequencies.
Robotic and endoscopic thyroidectomy are similar minimally invasive thyroid surgeries, each with its advantages, both of which can achieve the expected surgical outcomes.
Retrospectively registered.
机器人辅助和内镜甲状腺切除术在改善美容效果和术后生活质量方面优于传统的开放甲状腺切除术。这些甲状腺切除术在手术视野、可行性和侵袭性方面相似。然而，机器人辅助双侧腋窝-乳房入路（BABA）是否优于内镜双侧乳晕入路（BAA）甲状腺切除术仍不确定。本研究旨在探讨这两种手术的临床获益，通过比较分化型甲状腺癌患者内镜 BAA 和机器人辅助 BABA 甲状腺切除术的病理和手术结果，评估这两种手术方法的差异。
2018 年 11 月至 2021 年 9 月，278 例分化型甲状腺癌患者接受 BABA 机器人辅助手术，49 例接受 BAA 途径内镜甲状腺切除术。在这些患者中，我们使用 1:4 倾向评分匹配和回顾性队列研究方法分析了 42 例和 135 例内镜和机器人匹配对患者。通过手术结果、临床病理特征和术后并发症，对这两组进行回顾性比较。
EG 的平均手术时间明显长于 RG（p<0.001），ET 组的淋巴结检出数明显少于 RT 组（p<0.001）。EG 中甲状腺的平均最大直径明显大于 RG（p=0.04）。两组的总引流量和引流管插入天数无显著差异（p=0.241，p=0.316）。两组美容满意度（p=0.837）和疼痛评分（p=0.077）相似。并发症发生率无显著差异。
机器人和内镜甲状腺切除术是相似的微创甲状腺手术，各有优势，均能达到预期的手术效果。
回顾性注册。
