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Surgical Endoscopy

, Volume 34, Issue 2, pp 861–867 | Cite as

Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases

  • Jong-hyuk Ahn
  • Jin Wook YiEmail author
Article

Abstract

Background

Transoral endoscopic thyroid surgery vestibular approach (TOETVA) is a promising technique involving no skin incision. Since its first use in 60 patients in 2015, TOETVA has been adopted by several hospitals worldwide. However, reports of TOETVA for thyroid cancer are scarce.

Methods

Between August 2016 and March 2019, 150 and 125 thyroid cancer patients underwent TOETVA and open thyroidectomy (OT), respectively, by a single endocrine surgeon. Comparative analyses were performed on clinical and pathological findings, complications, and surgical completeness in total thyroidectomy cases, as indicated by the serum thyroglobulin (Tg) level. Data were collected prospectively and analyzed retrospectively.

Results

Mean age was younger in the TOETVA than in the OT group (43.06 ± 10.90 vs. 51.02 ± 12.42). The percentage of females was 96.7% in the TOETVA group. Total thyroidectomy was higher in the OT group (26.7% vs. 65.0%). Operation time (min) was longer in the TOETVA group for lobectomy (102.12 ± 32.59 vs. 76.38 ± 21.24) and total thyroidectomy (132.65 ± 34.79 vs. 90.71 ± 25.09). The largest tumor diameter was 0.91 (± 1.00) in the TOETVA group and 1.19 (± 1.07) in the OT group. The harvested lymph node number was not significantly different between the two groups for lobectomy (3.19 ± 2.89 vs. 3.49 ± 2.41, p = 0.319) and total thyroidectomy (4.98 ± 3.12 vs. 5.70 ± 4.35, p = 0.714). The thyroid-stimulating hormone stimulated Tg level before administration of the first dose of radioactive iodine was also not different (3.38 ± 10.87 vs. 3.44 ± 11.51, p = 0.595). Percentage of stimulated Tg below 1.0 ng/ml was 80.0% in the TOETVA group.

Conclusions

TOETVA is feasible in selected thyroid cancer patients, not only because it is cosmetically advantageous but also because it is oncologically safe. A large prospective cohort study including recurrence surveillance is needed to consolidate the feasibility of TOETVA.

Keywords

Thyroid cancer Endoscopic thyroid surgery Stimulated thyroglobulin Transoral thyroidectomy Remote access thyroid surgery Minimally invasive thyroid surgery 

Notes

Funding

The authors declare no sources of funding for this research.

Compliance with ethical standards

Disclosures

Dr. Jong-hyuk Ahn and Professor Jin Wook Yi have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryInha University HospitalIncheonRepublic of Korea
  2. 2.Department of SurgerySeoul National University Hospital, Seoul National University College of MedicineSeoulRepublic of Korea

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