Comparative Outcomes of Transoral Robotic and Open Thyroidectomy in Differentiated Thyroid Carcinoma < 2 cm: A Propensity Score‐Matched Study

BACKGROUND: Transoral robotic thyroidectomy (TORT) is a promising alternative to open thyroidectomy (OT) for managing differentiated thyroid carcinoma (DTC), especially in select low-risk patients. This study aimed to compare TORT and OT in patients with DTC < 2 cm using propensity score matching. METHODS: A retrospective analysis of 355 patients who underwent thyroidectomy between April 2020 and August 2024 was conducted. Of these, 100 underwent TORT and 255 underwent OT. Propensity score matching (1:1) yielded 70 patients per group. Outcomes included operative time, lymph node retrieval, complications, and hospital stay. RESULTS: TORT had significantly longer operative times than OT (151.2 ± 42.1 vs. 48.3 ± 11.1 min; p < 0.001). Central lymph node retrieval was comparable (4.5 ± 3.7 vs. 4.4 ± 3.5 nodes; p = 0.975). No cases of permanent vocal cord palsy occurred in either group. Transient hypoparathyroidism occurred in 3 TORT and 2 OT patients; permanent hypoparathyroidism in 1 TORT patient only (p > 0.05). Hospital stay was slightly longer for TORT (2.1 ± 0.7 vs. 1.8 ± 0.7 days; p = 0.011). No recurrences were observed during the median follow-up period of 29 months in the TORT group and 44 months in the OT group (p = 0.238). CONCLUSIONS: TORT demonstrated comparable short-term oncologic and surgical outcomes to OT in well-selected patients with DTC < 2 cm. Further studies with longer follow-up are needed to confirm long-term oncologic safety.