Department of Thyroid Surgery, Fujian Medical University Union Hospital, Fuzhou, FJ, China.
Clinical Research Center for Precision Management of Thyroid Cancer of Fujian Province, Fuzhou, FJ, China.
Surg Endosc. 2024 Nov;38(11):6586-6596. doi: 10.1007/s00464-024-11247-2. Epub 2024 Sep 16.
Thyroid surgery has undergone significant transformation with the introduction of minimally invasive techniques, particularly robotic and endoscopic thyroidectomy. These advancements offer improved precision and faster recovery but also present unique challenges. This study aims to compare the learning curves, operational efficiencies, and patient outcomes of robotic versus endoscopic thyroidectomy.
A retrospective cohort study was conducted, analyzing 258 robotic (da Vinci) and 214 endoscopic thyroidectomy cases. Key metrics such as operation duration, drainage volume, lymph node dissection outcomes, and hypoparathyroidism incidence were assessed to understand surgical learning curves and efficiency.
Robotic thyroidectomy showed a longer learning curve with initially longer operation times and higher drainage volumes but superior lymph node dissection outcomes. Both techniques were safe, with no permanent hypoparathyroidism or recurrent laryngeal nerve damage reported. The study delineated four distinct stages in the robotic and endoscopic surgery learning curve, each marked by specific improvements in proficiency. Endoscopic thyroidectomy displayed a shorter learning curve, leading to quicker operational efficiency gains.
Robotic and endoscopic thyroidectomies are viable minimally invasive approaches, each with its learning curves and efficiency metrics. Despite initial challenges and a longer learning period for robotic surgery, its benefits in complex dissections may justify specialized training. Structured training programs tailored to each technique are crucial for improving outcomes and efficiency. Future research should focus on optimizing training protocols and increasing accessibility to these technologies, enhancing patient care in thyroid surgery.
随着微创技术的引入，甲状腺手术发生了重大变革，特别是机器人和内镜甲状腺切除术。这些进步提供了更高的精度和更快的恢复速度，但也带来了独特的挑战。本研究旨在比较机器人与内镜甲状腺切除术的学习曲线、手术效率和患者结局。
进行了一项回顾性队列研究，分析了 258 例机器人（达芬奇）和 214 例内镜甲状腺切除术病例。评估了手术持续时间、引流体积、淋巴结清扫结果和甲状旁腺功能减退症发生率等关键指标，以了解手术学习曲线和效率。
机器人甲状腺切除术的学习曲线较长，初始手术时间较长，引流体积较大，但淋巴结清扫结果更好。两种技术均安全，无永久性甲状旁腺功能减退症或喉返神经损伤报告。本研究描绘了机器人和内镜手术学习曲线的四个不同阶段，每个阶段都以专业水平的特定提高为标志。内镜甲状腺切除术的学习曲线更短，手术效率提高更快。
机器人和内镜甲状腺切除术是可行的微创方法，每种方法都有其学习曲线和效率指标。尽管机器人手术最初存在挑战且学习周期较长，但在复杂解剖中具有优势，可能证明专门培训是合理的。针对每种技术量身定制的结构化培训计划对于改善手术结果和效率至关重要。未来的研究应侧重于优化培训方案并增加对这些技术的可及性，以提高甲状腺手术的患者护理水平。
