经口腔机器人甲状腺切除术与开放甲状腺切除术治疗<2 cm分化型甲状腺癌的疗效比较：一项倾向性评分匹配研究
Comparative Outcomes of Transoral Robotic and Open Thyroidectomy in Differentiated Thyroid Carcinoma < 2 cm: A Propensity Score-Matched Study.
文献信息
| PMID | 42954063 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Hyun Soo Cho |
| 作者单位 | Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea. |
| 期刊 | Journal of surgical oncology |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 经口腔机器人甲状腺切除术（TORT）是治疗分化型甲状腺癌（DTC）的一种有前景的开放甲状腺切除术（OT）替代方案，尤其适用于部分低危患者。本研究旨在采用倾向性评分匹配比较TORT与OT在<2 cm DTC患者中的疗效。
方法： 对2020年4月至2024年8月期间接受甲状腺切除术的355例患者进行回顾性分析。其中100例接受TORT，255例接受OT。倾向性评分匹配（1:1）后每组各70例。结局包括手术时间、淋巴结清扫数目、并发症和住院时间。
结果： TORT的手术时间显著长于OT（151.2 ± 42.1 vs. 48.3 ± 11.1 min；p < 0.001）。中央区淋巴结清扫数目相当（4.5 ± 3.7 vs. 4.4 ± 3.5枚；p = 0.975）。两组均无永久性声带麻痹病例。暂时性甲状旁腺功能减退发生于3例TORT和2例OT患者；永久性甲状旁腺功能减退仅见于1例TORT患者（p > 0.05）。TORT的住院时间略长（2.1 ± 0.7 vs. 1.8 ± 0.7天；p = 0.011）。TORT组中位随访29个月、OT组中位随访44个月期间，均未观察到复发（p = 0.238）。
结论： 在经过良好选择的<2 cm DTC患者中，TORT显示出与OT相当的短期肿瘤学和安全手术结局。仍需更长期随访的进一步研究以确认长期肿瘤学安全性。
英文摘要
BACKGROUND: Transoral robotic thyroidectomy (TORT) is a promising alternative to open thyroidectomy (OT) for managing differentiated thyroid carcinoma (DTC), especially in select low-risk patients. This study aimed to compare TORT and OT in patients with DTC < 2 cm using propensity score matching.
METHODS: A retrospective analysis of 355 patients who underwent thyroidectomy between April 2020 and August 2024 was conducted. Of these, 100 underwent TORT and 255 underwent OT. Propensity score matching (1:1) yielded 70 patients per group. Outcomes included operative time, lymph node retrieval, complications, and hospital stay.
RESULTS: TORT had significantly longer operative times than OT (151.2 ± 42.1 vs. 48.3 ± 11.1 min; p < 0.001). Central lymph node retrieval was comparable (4.5 ± 3.7 vs. 4.4 ± 3.5 nodes; p = 0.975). No cases of permanent vocal cord palsy occurred in either group. Transient hypoparathyroidism occurred in 3 TORT and 2 OT patients; permanent hypoparathyroidism in 1 TORT patient only (p > 0.05). Hospital stay was slightly longer for TORT (2.1 ± 0.7 vs. 1.8 ± 0.7 days; p = 0.011). No recurrences were observed during the median follow-up period of 29 months in the TORT group and 44 months in the OT group (p = 0.238).
CONCLUSIONS: TORT demonstrated comparable short-term oncologic and surgical outcomes to OT in well-selected patients with DTC < 2 cm. Further studies with longer follow-up are needed to confirm long-term oncologic safety.