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Transoral endoscopic thyroidectomy using the vestibular approach with an endoscopic retractor in thyroid cancer: experience with the first 132 patients

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Abstract

Background

Transoral endoscopic thyroidectomy using the vestibular approach (TOETVA) is a novel technique for thyroid cancer surgery. We aimed to review our initial experiences with TOETVA for the management of thyroid carcinoma, using retrospective analyses of a larger single-center case series.

Methods

From September 2016 to April 2018, 132 patients with thyroid cancer underwent TOETVA. A three-port technique through the oral vestibule was used to perform endoscopic thyroidectomy with ipsilateral central compartment dissection using conventional laparoscopic instruments, and an endoscopic retractor that we developed.

Results

All patients had papillary thyroid carcinoma. Less-than total or total thyroidectomy with ipsilateral central compartment node dissection was performed (124 vs. 8). The mean operation time was 87.6 min (range 56–213 min). The average number of lymph nodes resected was 2.6 (range 1—12). Six patients experienced transient hoarseness, which was resolved within 3 months. Most of the patients were discharged within 3 days after surgery.

Conclusions

In this large series from a single center, we found that TOETVA with the endoscopic retractor can be performed safely and radically in selected patients with thyroid cancer.

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Authors and Affiliations

  1. Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, Korea

    Soo Young Kim, Seok-Mo Kim, Hojin Chang, Bup-Woo Kim, Yong Sang Lee, Cheong Soo Park & Hang-Seok Chang

  2. Division of Endocrine Surgery, Department of General Surgery, School of Medicine, Ege University, Bornova, Izmir, Turkey

    Özer Makay

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  1. Soo Young Kim
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  2. Seok-Mo Kim
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  3. Özer Makay
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  4. Hojin Chang
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  5. Bup-Woo Kim
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  6. Yong Sang Lee
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  8. Hang-Seok Chang
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Correspondence to Seok-Mo Kim.

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Disclosure

Drs. Soo Young Kim, Seok-Mo Kim, Özer Makay, Hojin Chang, Bup-Woo Kim, Yong Sang Lee, Cheong Soo Park, and Hang-Seok Chang have no conflicts of interest or financial ties to disclose.

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Kim, S.Y., Kim, SM., Makay, Ö. et al. Transoral endoscopic thyroidectomy using the vestibular approach with an endoscopic retractor in thyroid cancer: experience with the first 132 patients. Surg Endosc 34, 5414–5420 (2020). https://doi.org/10.1007/s00464-019-07336-2

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  • DOI: https://doi.org/10.1007/s00464-019-07336-2

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