ArticleWorld journal of surgical oncology2025
Oncologic adequacy and outcomes of open, transoral endoscopic, and robotic thyroidectomy for papillary thyroid carcinoma: a propensity score-matched analysis.
Article in World journal of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 3 of them syntheses that pooled it.
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Who cites it
3 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Perioperative outcomes of transoral endoscopic vs. robotic thyroidectomy: a systematic review and meta-analysis.Journal of robotic surgery · 2026Pooled it
- A systematic review and meta-analysis: surgical outcomes comparing transoral robotic and open approaches to thyroidectomy.Journal of robotic surgery · 2026Pooled it
- Efficacy and safety of transoral endoscopic thyroidectomy vestibular approach of papillary thyroid carcinoma: a network meta-analysis.Frontiers in oncology · 2026Pooled it
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2 authors.
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Abstract
backgroundTransoral thyroidectomy, including transoral endoscopic thyroidectomy vestibular approach (TOETVA) and transoral robotic thyroidectomy (TORT), offers cosmetic advantages over conventional open thyroidectomy (OT). However, few studies have directly compared these three approaches in a single analysis. We evaluated the oncological adequacy and perioperative outcomes of OT, TOETVA, and TORT for papillary thyroid carcinoma using propensity score matching (PSM).
methodsWe retrospectively reviewed 819 consecutive patients who underwent OT (n = 559), TOETVA (n = 128), or TORT (n = 132) between 2016 and 2023. PSM was performed using 10 baseline clinicopathological variables to create three balanced cohorts (n = 124 each). The outcomes included central lymph node (LN) yield, complications, operative time, postoperative pain, hospital stay, and thyroglobulin and radioactive iodine (RAI) parameters.
resultsAfter matching, OT and TORT achieved similar central LN yields (7.1 ± 5.4 vs. 6.9 ± 2.9), both significantly higher than TOETVA (4.8 ± 2.8; p < 0.001). Hospital stay was shortest in the OT group (2.8 ± 1.7 days), intermediate in the TORT group (3.3 ± 0.7), and longest in the TOETVA group (4.0 ± 1.9; p < 0.001). Operation-day pain was lowest in the OT group (2.6 ± 0.5), intermediate in the TORT group (3.2 ± 0.9), and highest in the TOETVA group (3.8 ± 0.9; p < 0.001). Transient vocal cord palsy occurred least frequently in the TORT group (1.6%), followed by the TOETVA (7.3%) and OT (8.1%) groups (p = 0.056). The rates of permanent palsy and hypocalcemia were similar between the groups. The operative time was significantly longer in the TORT group than in the OT or TOETVA groups. Thyroglobulin levels and RAI parameters did not differ significantly between the groups.
conclusionsBoth transoral approaches were safe and feasible. TORT achieved oncologic adequacy comparable to that of OT while providing scarless benefits despite prolonged operative time. TOETVA was feasible but was associated with a low LN yield. The choice of the surgical approach should be individualized according to oncological adequacy, recovery, and cosmetic preferences.
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