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Transoral and submental endoscopic thyroidectomy (TOaST) for early stage papillary thyroid carcinoma: a real-world data retrospective cohort study

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Abstract

Introduction

Although transoral endoscopic thyroidectomy (TOETVA) is widely utilized in clinical practice, some problems and restrictions still remain. Our study compared the perioperative features and early surgical efficacy of TOETVA and a modified transoral and submental endoscopic thyroidectomy (TOaST) in early stage papillary thyroid carcinoma (PTC).

Methods

The clinical data of PTC patients who underwent endoscopic thyroidectomy, including 42 modified TOaST patients and 114 traditional TOETVA patients, were retrospectively collected. Propensity score matching was employed to reduce patient selection bias. The perioperative features and early surgical efficacy data of two groups were compared.

Results

The operation time of the TOaST group was significantly shorter than that of the TOETVA group (150.00 ± 35.47 min vs. 168.75 ± 44.49 min; P = 0.030). Furthermore, the TOaST group required shorter days for a normal diet (3.38 ± 0.93 days vs. 4.04 ± 1.03 days; P = 0.000) and a shorter hospital stay than the TOETVA group (5.85 ± 2.17 days vs. 6.12 ± 2.01 days; P = 0.003). There was no statistical difference in complications between the two groups, but the probability of numbness of the lower lip and chin in the TOaST group was lower than that in the TOETVA group(5.12% vs. 13.04%, P = 0.321). The symptoms of mandibular numbness and hoarseness of most patients were relieved in both groups 6 months after surgery, and no abnormalities and recurrence were found in the thyroid ultrasound. All the patients were satisfied with the appearance of their surgical incision.

Conclusion

In early stage PTC patients, TOaST had the same surgical effectiveness as traditional TOETVA but can minimize the probability of mandibular numbness and improve the perioperative quality of life.

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Funding

Academician He Lin Research Foundation of Affiliated Hospital of Jining Medical University (JYHL2022FMS10).

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Authors and Affiliations

  1. Department of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, 272000, Shandong, China

    Teng Ma, Peng Shi, Mei Liang & Yafei Shi

  2. Qingdao Medical College, Qingdao University, Qingdao, 266000, Shandong, China

    Teng Ma & Xueyan Zhang

  3. Department of Cardiovascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong, China

    Lulu Wang

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  1. Teng Ma
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  2. Peng Shi
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  4. Mei Liang
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  6. Yafei Shi
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Contributions

TM designed the study, analysed the data and commented on the manuscript at all stages. LW, XZ collected the data. PS, ML revised the manuscript. YS provided the research direction.

Corresponding author

Correspondence to Yafei Shi.

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Disclosures

Teng Ma, Peng Shi, Xueyan Zhang, Mei Liang, Lulu Wang, Yafei Shi have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the Affiliated Hospital of Jining Medical University ethics committee (2022C100).

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Ma, T., Shi, P., Zhang, X. et al. Transoral and submental endoscopic thyroidectomy (TOaST) for early stage papillary thyroid carcinoma: a real-world data retrospective cohort study. Surg Endosc 37, 7649–7657 (2023). https://doi.org/10.1007/s00464-023-10315-3

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