Retrospective propensity score-matched comparison of robotic versus open bilateral lateral neck dissection in papillary thyroid carcinoma with bilateral lateral neck metastasis.

BACKGROUND

Our study aimed to evaluate and compare the surgical and oncological outcomes of robotic bilateral lateral neck dissection (LND) via the bilateral axillo-breast approach (BABA) with the conventional open procedures (COP) in patients with papillary thyroid carcinoma (PTC) and bilateral lateral neck metastasis (LNM).

METHODS

The clinical data of 181 patients with PTC and bilateral LNM who underwent robotic bilateral LND or COP (61:120) between April 2018 and February 2024 at our institution were retrospectively analyzed. 36 matched pairs were generated using a 1:1 propensity score matching (PSM) method.

RESULTS

All robotic BABA bilateral LND procedures were successfully completed without conversion to open surgery. PSM analysis revealed that the postoperative stay, drainage volume, and the numbers of retrieved or metastatic lymph nodes were comparable between the matched groups. However, the operating time was significantly longer in the robotic group compared to the open group (p < 0.001). Furthermore, there were no significant differences between the two groups in terms of hypoparathyroidism (p = 0.637), vocal cord palsy (p = 1), and chyle leakage (p = 1). Additionally, there was no recurrence in either group. Notably, the aesthetic score was significantly higher in the robotic group compared to the open group (median, [IQR] 9 [IQR: 8-10] versus. 5 [IQR: 3-5], p < 0.001).

CONCLUSIONS

Robotic BABA bilateral LND resulted in comparable surgical outcomes and superior cosmetic in a cohort of patients with papillary thyroid carcinoma and bilateral lateral neck metastasis.