Skip to main content

Advertisement

SpringerLink
Log in

Transoral endoscopic thyroidectomy by vestibular approach in Viet Nam: surgical outcomes and long-term follow-up

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

The transoral endoscopic thyroidectomy by vestibular approach (TOETVA) has been developed for early-stage thyroid cancer treatment as well as benign thyroid nodules worldwide including Viet Nam, with low rate of complications and excellent results. However, there has not been any comprehensive studies with a large number of patients and long-term follow-up in our country. Therefore, we conducted this study to evaluate the results of treatment by TOETVA for benign and malignant lesions of thyroid gland in Viet Nam.

Methods

A prospective study was performed on 326 eligible patients who underwent TOETVA due to thyroid cancer and benign thyroid nodules in Department of Oncology and Palliative Care, Hanoi Medical University Hospital from July 2018 to April 2021. The clinical, surgical, and pathological characteristics, postoperative complications, and visual analog scale (VAS, 0–10 cm) score in day 1, 4, and 7 after surgery, long-term oncological and surgical outcomes were recorded.

Results

The mean age was 36.9 ± 9.8 years. 231 patients (70.9%) were diagnosed with differentiated cancer and 95 patients (29.1%) were diagnosed benign tumors of thyroid gland. In the cancer group, 12 patients (5.2%) undergone TOETVA had T3b-intraoperative-stage diagnosis, 219 patients (92.2%) were diagnosed T1 according to AJCC 8th. After 1 month of surgery, among thyroid cancer patients, there was no abnormality reported by thyroid scintigraphy and neck ultrasound as well as in unstimulated-Tg and anti-Tg values. The mean number lymph-node dissected in the cancer group was 6.1 ± 4.1 (range 0–21 nodes). However, only 2.6 ± 1.8 metastasis nodes were discovered (range 1–8 nodes), and the maximum size of these nodes was less than 2 mm. 81 patients presented occult lymph-node metastasis among thyroid cancer patients with cN0 stage (account for 35%). The occult lymph-node metastasis was 34.2% and 50% in patients diagnosed with T1 and T3b groups, respectively. The median postoperative hospital stay was 5.4 ± 0.7 days. Postoperatively, transient hypoparathyroidism was recorded in 12 patients (4.8%), transient hoarse was noted in 9 patients (3.6%), and numb chin was identified in 7 patients (2.8%). No permanent complication was noted. VAS score on first postoperative day was 4.5 ± 0.8. Median follow-up time was 12 (3–25) months. No recurrence was recorded.

Conclusions

TOETVA is an innovative and revolutionary technique in the treatment of benign thyroid nodules, as well as early-stage differentiated thyroid cancer. The results of oncology, postoperative complications, and satisfied outcomes supported the wide application of TOETVA in Viet Nam.

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

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. 900-world-fact-sheets.pdf. https://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf. Accessed 24 May 2021

  2. Jiang W-J, Yan P-J, Zhao C-L et al (2020) Comparison of total endoscopic thyroidectomy with conventional open thyroidectomy for treatment of papillary thyroid cancer: a systematic review and meta-analysis. Surg Endosc 34(5):1891–1903. https://doi.org/10.1007/s00464-019-07283-y

    Article  PubMed  Google Scholar 

  3. Ohgami M, Ishii S, Arisawa Y et al (2000) Scarless endoscopic thyroidectomy: breast approach for better cosmesis. Surg Laparosc Endosc Percutan Tech 10(1):1–4

    Article  CAS  Google Scholar 

  4. Bellantone R, Lombardi CP, Bossola M et al (2002) Video-assisted vs conventional thyroid lobectomy: a randomized trial. Arch Surg Chic III 137(3):301–304. https://doi.org/10.1001/archsurg.137.3.301

    Article  Google Scholar 

  5. Anuwong A (2016) Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg 40(3):491–497. https://doi.org/10.1007/s00268-015-3320-1

    Article  PubMed  Google Scholar 

  6. Al HNX et (2021) Preliminary experience with transoral endoscopic thyroidectomy and parathyroidectomy via vestibular approach. Ann Roman Soc Cell Biol 2021:3206–3215

    Google Scholar 

  7. Zhang G, Li B, Zhang G, Lin Y, Chen Y, Gao J (2020) Pros and cons of transoral endoscopic thyroidectomy via vestibular approach: a comparative study. Surg Laparosc Endosc Percutan Tech 31(3):331–336. https://doi.org/10.1097/SLE.0000000000000875

    Article  PubMed  Google Scholar 

  8. Nguyen HX, Nguyen HX, Nguyen HV, Nguyen LT, Nguyen TTP, Le QV (2021) Transoral endoscopic thyroidectomy by vestibular approach with central lymph node dissection for thyroid microcarcinoma. J Laparoendosc Adv Surg Tech A 31(4):410–415. https://doi.org/10.1089/lap.2020.0411

    Article  PubMed  Google Scholar 

  9. Dionigi G, Bacuzzi A, Lavazza M et al (2017) Transoral endoscopic thyroidectomy: preliminary experience in Italy. Updat Surg 69(2):225–234. https://doi.org/10.1007/s13304-017-0436-x

    Article  Google Scholar 

  10. Peng W, Peng XW, Li Z (2018) Application of transoral endoscopic thyroidectomy for benign thyroid nodule. J Clin Otorhinolaryngol Head Neck Surg 32(13):972–975. https://doi.org/10.13201/j.issn.1001-1781.2018.13.003

    Article  CAS  Google Scholar 

  11. Early outcomes in transoral vestibular thyroidectomy: robotic versus endoscopic techniques. https://pubmed.ncbi.nlm.nih.gov/29756254/. Accessed 6 May 2021

  12. Anuwong A, Sasanakietkul T, Jitpratoom P et al (2018) Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques and results. Surg Endosc 32(1):456–465. https://doi.org/10.1007/s00464-017-5705-8

    Article  PubMed  Google Scholar 

  13. Ahn J-H, Yi JW (2020) Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases. Surg Endosc 34(2):861–867. https://doi.org/10.1007/s00464-019-06841-8

    Article  PubMed  Google Scholar 

  14. Jitpratoom P, Ketwong K, Sasanakietkul T, Anuwong A (2016) Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy. Gland Surg 5(6):546–552. https://doi.org/10.21037/gs.2016.11.04

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kim SY, Kim S-M, Makay Ö et al (2020) Transoral endoscopic thyroidectomy using the vestibular approach with an endoscopic retractor in thyroid cancer: experience with the first 132 patients. Surg Endosc 34(12):5414–5420. https://doi.org/10.1007/s00464-019-07336-2

    Article  PubMed  Google Scholar 

  16. 704-viet-nam-fact-sheets.pdf. https://gco.iarc.fr/today/data/factsheets/populations/704-viet-nam-fact-sheets.pdf. Accessed 9 May 2021

  17. Matsuzu K, Sugino K, Masudo K et al (2014) Thyroid lobectomy for papillary thyroid cancer: long-term follow-up study of 1,088 cases. World J Surg 38(1):68–79. https://doi.org/10.1007/s00268-013-2224-1

    Article  PubMed  Google Scholar 

  18. Cho JS, Shin SH, Song YJ et al (2011) Is it possible to predict hypothyroidism after thyroid lobectomy through thyrotropin, thyroglobulin, anti-thyroglobulin, and anti-microsomal antibody? J Korean Surg Soc 81(6):380–386. https://doi.org/10.4174/jkss.2011.81.6.380

    Article  PubMed  PubMed Central  Google Scholar 

  19. Stoll SJ, Pitt SC, Liu J, Schaefer S, Sippel RS, Chen H (2009) Thyroid hormone replacement after thyroid lobectomy. Surgery 146(4):554–560. https://doi.org/10.1016/j.surg.2009.06.026

    Article  PubMed  Google Scholar 

  20. Le Van Q, Nguyen V, Hieu N, Nguyen X, Nguyen H (2018) Role of sentinel lymph node biopsy in papillary thyroid carcinoma in Viet Nam. Int J Hematol Oncol 30(4):230

    Google Scholar 

  21. Fernández-Ranvier GG, Guevara D, Alawwa G, Meknat A, Lieberman B, Inabnet WB (2021) Transoral endoscopic thyroidectomy vestibular approach (TOETVA): treatment for benign thyroid diseases. J Endocr Surg 21(1):13. https://doi.org/10.16956/jes.2021.21.1.13

    Article  Google Scholar 

  22. Anuwong A, Ketwong K, Jitpratoom P, Sasanakietkul T, Duh Q-Y (2018) Safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach. JAMA Surg 153(1):21–27. https://doi.org/10.1001/jamasurg.2017.3366

    Article  PubMed  Google Scholar 

  23. Russell JO, Razavi CR, Shaear M et al (2021) Transoral thyroidectomy: safety and outcomes of 200 consecutive North American cases. World J Surg 45(3):774–781. https://doi.org/10.1007/s00268-020-05874-8

    Article  PubMed  Google Scholar 

  24. Materazzi G, Dionigi G, Berti P et al (2007) One-day thyroid surgery: retrospective analysis of safety and patient satisfaction on a consecutive series of 1,571 cases over a three-year period. Eur Surg Res Eur Chir Forsch Rech Chir Eur 39(3):182–188. https://doi.org/10.1159/000100904

    Article  CAS  Google Scholar 

  25. Barczyński M, Cichoń S, Konturek A (2007) Which criterion of intraoperative iPTH assay is the most accurate in prediction of true serum calcium levels after thyroid surgery? Langenbecks Arch Surg 392(6):693–698. https://doi.org/10.1007/s00423-007-0165-6

    Article  PubMed  Google Scholar 

  26. Kqiku L, Sivic E, Weiglein A, Städtler P (2011) Position of the mental foramen: an anatomical study. Wien Med Wochenschr 161(9–10):272–273. https://doi.org/10.1007/s10354-011-0898-2

    Article  PubMed  Google Scholar 

  27. Nguyen XH, Nguyen XH, Mai TKN, Nguyen TTN, Tran NL, Le VQ (2019) Feasibility and safety of endoscopic thyroidectomy via a unilateral axillobreast approach for unilateral benign thyroid tumor in Viet Nam. Surg Laparosc Endosc Percutan Tech 29(6):447–450. https://doi.org/10.1097/SLE.0000000000000621

    Article  PubMed  Google Scholar 

  28. Nguyen HX, Nguyen LT, Nguyen HV et al (2020) Comparison of transoral thyroidectomy vestibular approach and unilateral axillobreast approach for endoscopic thyroidectomy: a prospective cohort study. J Laparoendosc Adv Surg Tech 31(1):11–17. https://doi.org/10.1089/lap.2020.0272

    Article  Google Scholar 

Download references

Acknowledgements

We thank our collages at Hanoi Medical University Hospital for their valuable help in the study.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Oncology, Hanoi Medical University, No 1 Ton That Tung Street, Dong Da District, Hanoi, Viet Nam

    Hau Xuan Nguyen, Thao Thi Phuong Nguyen & Quang Van Le

  2. Department of Oncology and Palliative Care, Hanoi Medical University Hospital, No 1 Ton That Tung Street, Dong Da District, Hanoi, 100000, Viet Nam

    Hau Xuan Nguyen, Hien Xuan Nguyen & Quang Van Le

Authors
  1. Hau Xuan Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hien Xuan Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thao Thi Phuong Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Quang Van Le
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: HauXN, HienXN and QVL. Administrative support: HXN and QVL. Collection and assembly of data: HienXN and TTPN. Data analysis and interpretation: HauXN, HienXN and TTPN. Manuscript writing: All authors. Final approval of manuscript: All authors. Accountable for all aspects of the work: All authors.

Corresponding author

Correspondence to Hien Xuan Nguyen.

Ethics declarations

Disclosures

Hau Xuan Nguyen, Hien Xuan Nguyen, Thao Thi Phuong Nguyen and Quang Van Le have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the ethics committee of the Hanoi Medical University Hospital.

Informed consent

Written informed consent was obtained from the patients.

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

Nguyen, H.X., Nguyen, H.X., Nguyen, T.T.P. et al. Transoral endoscopic thyroidectomy by vestibular approach in Viet Nam: surgical outcomes and long-term follow-up. Surg Endosc 36, 4248–4254 (2022). https://doi.org/10.1007/s00464-021-08759-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-021-08759-6

Keywords

Search

Navigation