Skip to main content
SpringerLink
Log in

Lessons Learned from the Transoral Endoscopic Thyroidectomy with Vestibular Approach (TOETVA) for the Treatment of Thyroid Carcinoma

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Early detection of thyroid carcinoma has become commonplace. Consequently, the endoscopic approach has become a widely used method.

Objective

Our aim was to report our experience with the transoral endoscopic thyroidectomy vestibular approach (TOETVA).

Methods

We reviewed the records of 46 patients who underwent TOETVA. Only patients with no regional lymph node metastases (N0) and fine needle aspiration biopsy-confirmed thyroid cancer were included. The surgical technique used was as described by Angkoon Anuwong.

Results

Forty-six patients with a mean age of 43.6 years (range 17–71) were included (37 women and 9 men). The mean time of surgery was 207 min (range 95–345), and the conversion to open thyroidectomy rate was 13% (six cases).

Conclusion

TOETVA is an acceptable approach for thyroid carcinoma. Poorly differentiated cancer, as well as extrathyroidal extension, result in patients being unsuitable for TOETVA. It is imperative to identify the circumstances under which conversion to open thyroidectomy must take place.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017;67(1):7–30.

    Article  PubMed  Google Scholar 

  2. Wiltshire JJ, Drake TM, Uttley L, Balasubramanian SP. Systematic review of trends in the incidence rates of thyroid cancer. Thyroid. 2016;26(11):1541–52.

    Article  PubMed  Google Scholar 

  3. Hüscher CS, Chiodini S, Napolitano C, Recher A. Endoscopic right thyroid lobectomy. Surg Endosc. 1997;11:877.

    Article  PubMed  Google Scholar 

  4. Kitano H, Fujimura M, Kinoshita T, Kataoka H, Hirano M, Kitajima K. Endoscopic thyroid resection using cutaneous elevation in lieu of insufflation. Surg Endosc. 2002;16:88–91.

    Article  CAS  PubMed  Google Scholar 

  5. Ohgami M, Ishii S, Arisawa Y, Ohmori T, Noga K, Furukawa T, et al. Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech. 2000;10:1–4.

    Article  CAS  PubMed  Google Scholar 

  6. Ikeda Y, Takami H, Niimi M, Kan S, Sasaki Y, Takayama J. Endoscopic thyroidectomy by the axillary approach. Surg Endosc. 2001;15:1362–4.

    Article  CAS  PubMed  Google Scholar 

  7. Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg. 2016;40(3):491–7.

    Article  PubMed  Google Scholar 

  8. Anuwong A, Sasanakietkul T, Jitpratoom P, Ketwong K, Kim HY, Dionigi G, et al. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques and results. Surg Endosc. 2018;32(1):456–65.

    Article  PubMed  Google Scholar 

  9. Li Y, Zhou X. Comparison between endoscopic thyroidectomy and conventional open thyroidectomy for papillary thyroid microcarcinoma: a meta-analysis. J Cancer Res Ther. 2016;12(2):550–5.

    Article  PubMed  Google Scholar 

  10. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Nixon IJ, Ganly I, Patel SG, Palmer FL, Whitcher MM, Ghossein R, et al. Changing trends in well differentiated thyroid carcinoma over eight decades. Int J Surg. 2012;10(10):618–23.

    Article  PubMed  Google Scholar 

  12. Shaha AR, Tuttle RM, Shah JP. Papillary microcarcinoma of the thyroid. J Surg Oncol. 2007;95(7):532–3.

    Article  PubMed  Google Scholar 

  13. Lee J, Yun JH, Choi UJ, Kang SW, Jeong JJ, Chung WY. Robotic versus endoscopic thyroidectomy for thyroid cancers: a multi-institutional analysis of early postoperative outcomes and surgical learning curves. J Oncol 2012;2012:734541.

    PubMed  PubMed Central  Google Scholar 

  14. Dionigi G, Chai YJ, Tufano RP, Anuwoung A, Kim HY. Transoral endoscopic thyroidectomy via a vestibular approach: Why and how? Endocrine 2018;59(2):275–9.

    Article  CAS  PubMed  Google Scholar 

  15. Kandil EH, Noureldine SI, Yao L, Slakey DP. Robotic tans axillary thyroidectomy: an examination of the first one hundred cases. J Am Coll Surg. 2012;214:558–64.

    Article  PubMed  Google Scholar 

  16. Anuwong A, Ketwong K, Jitpratoom P, Sasanakietkul T, Duh QY. Safety and Outcomes of the Transoral Endoscopic Thyroidectomy Vestibular Approach. JAMA Surg. 2018;153(1):21–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Head and Neck Surgery, Instituto Nacional de Cancerología, Mexico CDMX, Mexico

    Kuauhyama Luna-Ortiz MD & Antonio Gómez-Pedraza MD

  2. Department of General Surgery (Head and Neck), Hospital General Manuel Gea Gonzalez, Mexico CDMX, Mexico

    Kuauhyama Luna-Ortiz MD

  3. Department of Surgery, Police General Hospital, Faculty of Medicine, Siam University, Bangkok, Thailand

    Angkoon Anuwong MD

Authors
  1. Kuauhyama Luna-Ortiz MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonio Gómez-Pedraza MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angkoon Anuwong MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antonio Gómez-Pedraza MD.

Ethics declarations

Disclosures

Drs. Kuauhyama Luna-Ortiz, Antonio Gómez-Pedraza, and Angkoon Anuwong have no conflicts of interest or financial ties to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Luna-Ortiz, K., Gómez-Pedraza, A. & Anuwong, A. Lessons Learned from the Transoral Endoscopic Thyroidectomy with Vestibular Approach (TOETVA) for the Treatment of Thyroid Carcinoma. Ann Surg Oncol 27, 1356–1360 (2020). https://doi.org/10.1245/s10434-019-07899-3

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-019-07899-3

Search

Navigation