Department of Surgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Surgery, KUMC Thyroid Center, Korea University College of Medicine, Korea University Hospital, Seoul, Korea.
Surgery. 2024 Dec;176(6):1627-1634. doi: 10.1016/j.surg.2024.08.005. Epub 2024 Sep 17.
Transoral robotic thyroidectomy has gained popularity as a promising approach for thyroid surgery owing to its improved cosmetic outcomes. The objective of this retrospective study was to describe the surgical and safety outcomes of 1,000 consecutive transoral robotic thyroidectomy cases.
1,000 consecutive patients who underwent transoral robotic thyroidectomy for thyroid disease were reviewed at a large metropolitan tertiary hospital (Seoul, Korea) between September 2012 and March 2022.
The study comprised 1,000 patients (815 women), with 891 cancer cases. Lobectomy was the most common procedure (89.4%), followed by total thyroidectomy (9.8%) and isthmusectomy (0.8%), and their respective mean total operative times were 173.8 ± 36.2, 236.8 ± 50.5, and 107.5 ± 19.8 minutes. An obvious learning curve was noted. The respective postoperative pain scores on postoperative days 0, 1, and 2 were 4.6 ± 1.3, 3.1 ± 0.8, and 2.5 ± 0.8. The mean postoperative hospital stay duration was 2.6 ± 0.9 days. Complications occurred in 3.6% of cases, including oral wound infection, skin flap burn, bleeding, chyle leakage, transient and permanent mental nerve injury, and transient and permanent recurrent laryngeal nerve injury. Transient hypoparathyroidism occurred in 4.1% of total thyroidectomy cases. Thirty-seven patients (4.2%) underwent additional radioactive iodine therapy. The median follow-up period was 39 months, and there were no cases of recurrence.
Under the expertise of an experienced surgeon, transoral robotic thyroidectomy results in favorable cosmetic outcomes, tolerable postoperative pain, and acceptable complication rates in carefully selected patients.
经口机器人甲状腺切除术因其改善的美容效果而成为一种有前途的甲状腺手术方法。本回顾性研究的目的是描述 1000 例连续经口机器人甲状腺切除术的手术和安全性结果。
在韩国首尔的一家大型都市三级医院，回顾了 2012 年 9 月至 2022 年 3 月期间因甲状腺疾病接受经口机器人甲状腺切除术的 1000 例连续患者。
本研究包括 1000 例患者（815 例女性），其中 891 例为癌症病例。叶切除术是最常见的手术（89.4%），其次是全甲状腺切除术（9.8%）和峡部切除术（0.8%），其各自的平均总手术时间分别为 173.8±36.2、236.8±50.5 和 107.5±19.8 分钟。明显存在学习曲线。术后第 0、1 和 2 天的术后疼痛评分分别为 4.6±1.3、3.1±0.8 和 2.5±0.8。平均术后住院时间为 2.6±0.9 天。3.6%的病例发生并发症，包括口腔伤口感染、皮瓣烧伤、出血、乳糜漏、暂时性和永久性喉返神经损伤以及暂时性和永久性甲状旁腺功能减退。全甲状腺切除术病例中 4.1%发生暂时性甲状旁腺功能减退。37 例（4.2%）患者行额外放射性碘治疗。中位随访时间为 39 个月，无复发病例。
在经验丰富的外科医生的专业知识下，经口机器人甲状腺切除术在精心挑选的患者中可获得良好的美容效果、可耐受的术后疼痛和可接受的并发症发生率。
