Observational cohort study on safety and efficacy of robotic thyroidectomy with super-meticulous capsular dissection versus open surgery for thyroid cancer: postoperative dynamic risk assessment of radioactive iodine therapy

作者：Xiangquan Qin, Yufan Zhang, Jia Luo, Lingjuan Zeng, Xia Liu, Ting Zhang, Lin Ren, Linjun Fan, Dingde Huang · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000002071 · 被引用次数：5 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Thyroid and Parathyroid Surgery、Management of metastatic bone disease

OBJECTIVE: To assess the efficacy and safety of robotic thyroidectomy (RT) with super-meticulous capsular dissection (SMCD) versus open thyroidectomy (OT), the authors used a dynamic risk assessment system incorporating 131 I-WBS along with radioactive iodine (RAI) efficacy evaluation. BACKGROUND: Currently, the therapeutic efficacy of robotic surgery remains controversial. The 131 I whole-body scan ( 131 I-WBS) dynamic risk assessment system can detect small residual thyroid tissues and lesions, which may be used as indicators for the surgical efficacy of RT or OT thyroidectomy in differentiated thyroid cancer (DTC). METHODS: This retrospective cohort study included 2349 patients who underwent total thyroidectomy followed by RAI therapy in our department between August 2017 and June 2023. Propensity score matching was performed at a ratio of 1:3 based on surgical type and mean follow-up duration to minimize selection bias after excluding those lost to follow-up. The primary outcome was surgical completeness, assessed using a dynamic risk system incorporating 131 I-WBS along with RAI efficacy evaluation. RESULTS: There was no significant difference in the number of metastatic lymph nodes removed between the two groups ( P =0.45). The incidence rate of parathyroid gland transplantation was 395 (68.7%) in the OT group and 8 (3.8%) in the RT group ( P <0.001). There were no differences in the thyroidectomy completeness based on the 3 h iodine uptake rate and 99m TcO 4- thyroid i...