Retrospective study of outcomes of transoral robotic and open thyroidectomy in differentiated thyroid carcinoma < 2 cm

Transoral robotic thyroidectomy (TORT) is a promising alternative to open thyroidectomy (OT) for managing differentiated thyroid carcinoma (DTC), especially in select low-risk patients. A retrospective study at Seoul National University (Seoul, South Korea) compared outcomes with TORT versus OT in patients with DTC < 2 cm. The study included 355 patients who underwent thyroidectomy between April 2020 and August 2024. Of these, 100 underwent TORT and 255 underwent OT. Propensity score matching (1:1) yielded 70 patients per group.TORT had significantly longer operation times than OT (median 151 versus 48 min; p<0.001). Central lymph node retrieval was comparable (median 4.5 versus 4.4 nodes; p=0.975). No cases of permanent vocal cord palsy occurred in either group. Transient hypoparathyroidism occurred in 3 TORT en 2 OT patients; permanent hypoparathyroidismin 1 TORT patient only (p>0.05). Hospital stay was slightly longer for TORT (2.1 versus 1.8 days; p=0.011). No recurrences were observed during the median follow-up of 29 months in the TORT group and 44 months in the OT group. The authors conclude that TORT demonstrated comparable short-term oncologic and surgical outcomes to OT in selected patients with DTC < 2 cm.