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.