Transoral thyroidectomy in a consecutive cancer-enriched cohort of 1–000 patients: a single-surgeon experience with endoscopic and robotic platforms
- 1Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine , ,
Abstract
Introduction: Transoral vestibular thyroidectomy, performed using an endoscopic (transoral endoscopic thyroidectomy via the vestibular approach [TOETVA]) or robot-assisted (transoral robotic thyroidectomy [TORT]) approach, is a scar-concealing alternative to open thyroidectomy. Given the paucity of large-scale single-surgeon studies spanning both platforms, the aim of this study was to characterize the clinicopathological and perioperative outcomes of a large cancer-enriched transoral thyroidectomy series and to examine differences between TOETVA and TORT.
Methods: We retrospectively reviewed 1–000 consecutive patients who underwent TOETVA (n=450) or TORT (n=550) performed by a single endocrine surgeon between September 2016 and May 2024. An additional propensity score-matched analysis incorporating clinical characteristics and calendar time, with exact matching on extent of surgery, was performed in the contemporaneous cohort after TORT introduction, yielding 221 matched pairs.
Results: Among the 1–000 cases, 986 (98.6%) were malignant, predominantly papillary thyroid carcinoma, with 99.8% at pathological stage I. Overall perioperative outcomes were acceptable, with low complication rates and infrequent drain use; recurrent laryngeal nerve palsy and mental nerve injury were confined to the early TOETVA period. In the overall cohort, TORT patients had larger tumors and more frequent T1b and N1a disease, with shorter operative time and hospital stay. After propensity score matching, between-platform differences were modest: TORT was associated with a 5.05-min longer operative time (95% CI, 0.39–9.72) and a 0.79-node higher central compartment node yield (95% CI, 0.18–1.41), whereas histopathological characteristics, hospital stay, and measured postoperative complications did not differ significantly. Sensitivity analyses yielded similar operative-time estimates.
Conclusions: In this large cancer-enriched single-surgeon cohort, transoral thyroidectomy was associated with acceptable perioperative outcomes in carefully selected patients. Although TOETVA and TORT showed differences in the overall cohort, adjusted differences were modest and did not establish superiority of either platform. Both approaches may retain practical value within an evolving transoral thyroidectomy practice.
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BibTeX
@article{kim2026transoral,
title = {{Transoral thyroidectomy in a consecutive cancer-enriched cohort of 1–000 patients: a single-surgeon experience with endoscopic and robotic platforms}},
author = {Nam Kyung Kim and Junu Kim and Jun Sung Lee and Hyeok Jun Yun and Seok-Mo Kim and Yong Sang Lee and Hang-Seok Chang},
journal = {Frontiers in endocrinology},
year = {2026},
month = sep,
doi = {10.3389/fendo.2026.1877246},
url = {https://europepmc.org/article/PMC/PMC13661338},
note = {CC BY},
}
RIS
TY - JOUR
TI - Transoral thyroidectomy in a consecutive cancer-enriched cohort of 1–000 patients: a single-surgeon experience with endoscopic and robotic platforms
AU - Nam Kyung Kim
AU - Junu Kim
AU - Jun Sung Lee
AU - Hyeok Jun Yun
AU - Seok-Mo Kim
AU - Yong Sang Lee
AU - Hang-Seok Chang
PY - 2026
DA - 2026/09/30
JO - Frontiers in endocrinology
DO - 10.3389/fendo.2026.1877246
UR - https://europepmc.org/article/PMC/PMC13661338
AB - Introduction: Transoral vestibular thyroidectomy, performed using an endoscopic (transoral endoscopic thyroidectomy via the vestibular approach [TOETVA]) or robot-assisted (transoral robotic thyroidectomy [TORT]) approach, is a scar-concealing alternative to open thyroidectomy. Given the paucity of large-scale single-surgeon studies spanning both platforms, the aim of this study was to characterize the clinicopathological and perioperative outcomes of a large cancer-enriched transoral thyroidectomy series and to examine differences between TOETVA and TORT. Methods: We retrospectively reviewed 1–000 consecutive patients who underwent TOETVA (n=450) or TORT (n=550) performed by a single endocrine surgeon between September 2016 and May 2024. An additional propensity score-matched analysis incorporating clinical characteristics and calendar time, with exact matching on extent of surgery, was performed in the contemporaneous cohort after TORT introduction, yielding 221 matched pairs. Results: Among the 1–000 cases, 986 (98.6%) were malignant, predominantly papillary thyroid carcinoma, with 99.8% at pathological stage I. Overall perioperative outcomes were acceptable, with low complication rates and infrequent drain use; recurrent laryngeal nerve palsy and mental nerve injury were confined to the early TOETVA period. In the overall cohort, TORT patients had larger tumors and more frequent T1b and N1a disease, with shorter operative time and hospital stay. After propensity score matching, between-platform differences were modest: TORT was associated with a 5.05-min longer operative time (95% CI, 0.39–9.72) and a 0.79-node higher central compartment node yield (95% CI, 0.18–1.41), whereas histopathological characteristics, hospital stay, and measured postoperative complications did not differ significantly. Sensitivity analyses yielded similar operative-time estimates. Conclusions: In this large cancer-enriched single-surgeon cohort, transoral thyroidectomy was associated with acceptable perioperative outcomes in carefully selected patients. Although TOETVA and TORT showed differences in the overall cohort, adjusted differences were modest and did not establish superiority of either platform. Both approaches may retain practical value within an evolving transoral thyroidectomy practice.
SN - 1664-2392
ER -