METHODS: This retrospective study analyzed patients undergoing completion thyroidectomy from 2010-2020, either by conventional open technique (n = 87) or a robotic remote-access approach (n = 44). Outcomes were compared between groups.
RESULTS: A total of 131 patients were included. The robotic cohort was younger (45.3 ± 14.0 vs 55.5 ± 14.5 years, P < 0.001) with a lower BMI (25.9 ± 5.5 vs 33.7 ± 7.8 kg/m2, P < 0.001). Operative time was longer for robotic procedures (139 min vs 99 min, P < 0.001). Hospital stay was shorter after robotic surgery, with 25% discharged the same day as compared to 5.7% in the open thyroidectomy cohort (P = 0.006). Overall rates of complication were comparable (P = 0.65). Transient recurrent laryngeal nerve palsy occurred in 4.6% of patients, which was similar between both cohorts (P = 0.66).
CONCLUSIONS: Robotic completion thyroidectomy appears safe and effective, achieving shorter hospitalization than conventional open approaches despite longer operative times. Appropriate patient selection and surgical technique optimization are key. Larger prospective studies should investigate costs and long-term patient-reported outcomes.
方法:这项回顾性研究分析了2010-2020年通过常规开放技术(n=87)或机器人远程访问方法(n=44)进行完全甲状腺切除术的患者。比较各组的结果。
结果:共纳入131例患者。机器人队列更年轻(45.3±14.0vs55.5±14.5岁,P<0.001),BMI较低(25.9±5.5vs33.7±7.8kg/m2,P<0.001)。机器人手术的手术时间更长(139分钟比99分钟,P<0.001)。机器人手术后住院时间更短,与开放甲状腺切除术队列中5.7%相比,25%的患者当天出院(P=0.006)。并发症的总发生率相当(P=0.65)。4.6%的患者出现短暂性喉返神经麻痹,这两个队列之间相似(P=0.66)。
结论:机器人完成甲状腺切除术安全有效,尽管手术时间较长,但住院时间比传统的开放式方法短。适当的患者选择和手术技术优化是关键。更大的前瞻性研究应调查成本和长期患者报告的结果。