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Transoral versus gasless transaxillary endoscopic thyroidectomy: a comparative study

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Abstract

This study aimed to compare the surgical safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and gasless endoscopic thyroidectomy transaxillary approach (GETTA). This retrospective study assessed 150 patients managed with the TOETVA at the Yantai Yuhuangding hospital and 150 patients managed via the GETTA at the Zhenjiang Provincial People’s Hospital. The procedures were compared in terms of workspace creation time, operating time, complications, post-operative complaints, cosmetic satisfaction, and the efficacy of central neck lymph-node dissection. There was no significant between-group difference in terms of post-operative complications. The average workspace creation and operating times were significantly shorter for GETTA than for TOETVA (P values for both < 0.001). The average number of lymph nodes dissected from the central compartment of the neck was higher in the TOETVA group than in the GETTA group (7.2 ± 4.6 vs. 3.9 ± 3.0, P < 0.001). The mean swallowing impairment index-6 scores at 1 month were significantly lower in the GETTA group than in the TOETVA group (1.5 ± 1.2 vs 2.6 ± 1.4, P < 0.001). Over 97% of all patients (both groups) were either satisfied or very satisfied with the cervical cosmetic outcomes at 3 months post-surgery (P = 0.099). TOETVA and GETTA are both safe procedures with good cervical cosmetic outcomes for well-selected patients. Although TOETVA is more efficacious in terms of central lymph nodes dissection, GETTA has a greater time–cost advantage.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Editage (http://www.editage.cn) for English language editing.

Funding

The authors received no specific funding for this work.

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Author notes

  1. Guibin Zheng and Jiajie Xu contributed equally to this study.

Authors and Affiliations

  1. Department of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, No. 20 East Yuhuangding Road, Yantai, 264000, Shandong, China

    Guibin Zheng, Guochang Wu, Chi Ma, Haiqing Sun & Haitao Zheng

  2. Department of Head and Neck Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, Zhejiang, 310014, China

    Jiajie Xu, Minghua Ge & Chuanming Zheng

Authors
  1. Guibin Zheng
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  2. Jiajie Xu
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  4. Chi Ma
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  5. Haiqing Sun
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  7. Haitao Zheng
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by GZ, JX, CM, GW, and HS. The first draft of the manuscript was written by GZ and JX. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Haitao Zheng or Chuanming Zheng.

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Conflict of interest

The authors have no financial or proprietary interests in any material discussed in this article.

Ethical approval

The authors declare under their responsibility that all the procedures followed in this study were in accordance with the ethical standards issued by the national health and family planning commission and with the Helsinki Declaration. The ethics committee of the affiliated Yantai Yuhuangding Hospital of Qingdao University approved this study (Approval No.: 2020-269).

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Informed consent were obtained from all patients involved in this study.

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Zheng, G., Xu, J., Wu, G. et al. Transoral versus gasless transaxillary endoscopic thyroidectomy: a comparative study. Updates Surg 74, 295–302 (2022). https://doi.org/10.1007/s13304-021-01062-y

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  • DOI: https://doi.org/10.1007/s13304-021-01062-y

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