Comparative Analysis of Transoral Robotic Thyroidectomy versus Bilateral Axillo-Breast Approach Robotic Thyroidectomy: A Retrospective Study with Propensity Score Matching

Presentation: C153
Topic: Thyroid Cancer
Type: Poster
Date: Thursday, April 19, 2018
Session: 9:00 AM - 7:00 PM
Authors: Hong Kyu Kim, MD1, Young Jun Chai, MD, PhD2, Gianlorenzo Dionigi, MD3, Eren Berber4, Ralph P. Tufano, MD5, Hoon Yub Kim, MD, PhD1
Institution(s): 1Korea University College of Medicine, 2Seoul National University Boramae Medical Center, 3Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital “G. Martino”, 4Center for Endocrine Surgery, Cleveland Clinic, 5The Johns Hopkins University School of Medicine

Background: TORT through oral vestibule draws attention recently because it requires minimal flap dissection and postoperative scar disappears in several weeks. In this study, we evaluated surgical outcomes of TORT and compared them with those of bilateral axillo-breast approach robotic thyroidectomy (BABA RT) after propensity score matching.

Method: The medical reports were retrospectively reviewed. A propensity score matching analysis was done with seven covariates including age, gender, tumor size, extrathyroidal invasion, pathologic diagnosis, multiplicity and thyroiditis.

Results: Propensity score matching identified 86 pairs of patients. There were 83 and 80 females in BABA RT and TORT group, respectively. The mean tumor size was 1.1 and 1.0 cm for BABA RT and TORT group, respectively. Operation time for total thyroidectomy was shorter in TORT than BABA RT group (220.3 vs. 301.9 min, p = 0.023). Mean postoperative pain scores at operation day 0 and 1, and analgesic requirement were lower in TORT group. Hospital stay was shorter in TORT than BABA RT group. There were no significant differences between TORT and BABA RT group in transient vocal cord palsy rate (1.1% vs. 4.0%) and transient hypoparathyroidism rate (0% vs. 10.8%).

Conclusion: TORT could be performed safely and showed comparable outcomes with BABA RT in selected patients. TORT might be an alternative approach for the patients who want scarless thyroidectomy.