Retrospective comparative study of early postoperative complications and recovery following modified gasless subclavian endoscopic thyroidectomy in patients with papillary thyroid carcinoma at different tumor stages.
- 1Department of General Surgery, Liyang People's Hospital, Liyang, China.
- 2Department of Oncology, Zhenjiang First People's Hospital, Zhenjiang, China.
Abstract
Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the endocrine system. Modified gasless subclavian endoscopic thyroidectomy has been increasingly used because of its minimally invasive nature and cosmetic advantages. However, postoperative complications may adversely affect patient recovery, and reliable risk prediction tools remain limited. This study aimed to compare early postoperative complications and recovery outcomes among patients with PTC at different tumor stages and to develop a model for predicting postoperative complications. A total of 212 patients with PTC who underwent gasless subclavian endoscopic thyroidectomy were retrospectively enrolled. The primary outcome was the occurrence of overall postoperative complications. Multivariable logistic regression analysis was performed to identify independent risk factors and establish a predictive model. The discriminatory ability of the model was evaluated using the receiver operating characteristic (ROC) curve, calibration performance was assessed using calibration curves, and clinical utility was evaluated through decision curve analysis (DCA). Postoperative complications occurred in 71 patients (33.49%). Multivariable analysis demonstrated that T2-T3 stage [odds ratio (OR) =4.72], total thyroidectomy (OR =4.70), central lymph node dissection (CLND) (OR =4.25), and prolonged operative time (OR =1.05/min) were independent risk factors (all P<0.05). The combined predictive model showed favorable predictive performance, with an area under the curve (AUC) of 0.8757 [95% confidence interval (CI): 0.8272-0.9242], along with good calibration and clinical applicability. Hypocalcemia was the most common postoperative complication, while recurrent laryngeal nerve injury occurred more frequently in patients with advanced-stage disease. Tumor stage, surgical extent, and operative complexity are important factors influencing postoperative complications in patients with PTC. The proposed predictive model demonstrated good risk assessment capability and may provide a useful reference for individualized perioperative management.
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BibTeX
@article{zhou2026retrospective,
title = {{Retrospective comparative study of early postoperative complications and recovery following modified gasless subclavian endoscopic thyroidectomy in patients with papillary thyroid carcinoma at different tumor stages.}},
author = {Ping Zhou and Yao Qian and Jiayue Zhang and Meiying Cheng},
journal = {Gland surgery},
year = {2026},
month = sep,
doi = {10.21037/gs-2026-0379},
url = {https://europepmc.org/article/MED/42996551},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Retrospective comparative study of early postoperative complications and recovery following modified gasless subclavian endoscopic thyroidectomy in patients with papillary thyroid carcinoma at different tumor stages.
AU - Ping Zhou
AU - Yao Qian
AU - Jiayue Zhang
AU - Meiying Cheng
PY - 2026
DA - 2026/09/30
JO - Gland surgery
DO - 10.21037/gs-2026-0379
UR - https://europepmc.org/article/MED/42996551
AB - Papillary thyroid carcinoma (PTC) is the most common malignant tumor of the endocrine system. Modified gasless subclavian endoscopic thyroidectomy has been increasingly used because of its minimally invasive nature and cosmetic advantages. However, postoperative complications may adversely affect patient recovery, and reliable risk prediction tools remain limited. This study aimed to compare early postoperative complications and recovery outcomes among patients with PTC at different tumor stages and to develop a model for predicting postoperative complications. A total of 212 patients with PTC who underwent gasless subclavian endoscopic thyroidectomy were retrospectively enrolled. The primary outcome was the occurrence of overall postoperative complications. Multivariable logistic regression analysis was performed to identify independent risk factors and establish a predictive model. The discriminatory ability of the model was evaluated using the receiver operating characteristic (ROC) curve, calibration performance was assessed using calibration curves, and clinical utility was evaluated through decision curve analysis (DCA). Postoperative complications occurred in 71 patients (33.49%). Multivariable analysis demonstrated that T2-T3 stage [odds ratio (OR) =4.72], total thyroidectomy (OR =4.70), central lymph node dissection (CLND) (OR =4.25), and prolonged operative time (OR =1.05/min) were independent risk factors (all P<0.05). The combined predictive model showed favorable predictive performance, with an area under the curve (AUC) of 0.8757 [95% confidence interval (CI): 0.8272-0.9242], along with good calibration and clinical applicability. Hypocalcemia was the most common postoperative complication, while recurrent laryngeal nerve injury occurred more frequently in patients with advanced-stage disease. Tumor stage, surgical extent, and operative complexity are important factors influencing postoperative complications in patients with PTC. The proposed predictive model demonstrated good risk assessment capability and may provide a useful reference for individualized perioperative management.
SN - 2227-684X
SN - 2227-8575
ER -