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
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: 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. Methods: 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). Results: 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. Conclusions: 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.
Source: Gland Surgery
Authors: Ping Zhou, Yao Qian, Jiayue Zhang, Meiying Cheng
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223805367