Background In search of an ideal cosmesis, transoral endoscopic thyroidectomy via vestibular approach (TOETVA) has recently been introduced to avoid a visible scar. Although ambulatory thyroid surgery is considered safe in carefully selected patients, this remains unclear for TOETVA. Methods All consecutive adult patients who underwent ambulatory TOETVA or open thyroid surgery at a French university hospital were prospectively enrolled from 12/2020 until 11/2021. The primary outcome was postoperative morbidity (recurrent laryngeal nerve (RLN) palsy, re-intervention for bleeding, wound morbidity, or hospital readmission). The secondary outcome was quality of life (QoL), measured by a survey including a validated questionnaire (SF-12) and a modified thyroid surgery questionnaire six weeks after surgery. Results Throughout the study period, 374 patients underwent a unilateral lobectomy or isthmectomy in ambulatory setting, of which 34 (9%) as TOETVA (including 21 (62%) for a possible malignancy). In the TOETVA group, younger age (median 40 vs. 51 (40-60) years, P \ 0.001) and lower BMI (median 23.1 (20.9-25.4) vs. 24.9 (22.1-28.9) kg/m 2 , P = 0.001) were noted. No cases were converted to open cervicotomy. TOETVA was at least as good as open cervicotomy with nil versus four (1%) re-interventions for bleeding, one temporary (5%) versus 13 (4%) (temporary) RLN palsies, and one (\1%) wound infection (open cervicotomy group). No hospital readmissions occurred in all ambulatory surgery patients. No differences were found in physical (P = 0.280) and mental (P = 0.569) QoL between TOETVA and open surgery. Conclusions In carefully selected patients, the feasibility and safety of ambulatory TOETVA are comparable to open surgery.

Objective: Describe the diagnostic work-up and postoperative results for patients treated by adrenalectomy for primary aldosteronism in France from 2010 to 2020 Summary Background Data: Primary aldosteronism (PA) is the underlying cause of hypertension in 6-18% patients. French and international guidelines recommend CT-scan and adrenal vein sampling as part of diagnostic work-up to distinguish unilateral PA amenable to surgical treatment, from bilateral PA that will require lifelong antialdosterone treatment. Adrenalectomy for unilateral primary aldosteronism has been associated with complete resolution of hypertension (no antihypertensive drugs and normal ambulatory pressure) in about 1/3 of patients, and complete biological success in 94% of patients. These results are mainly based on retrospective studies with short follow-up and aggregated patients from various international high volume centres. Methods: Here we report results from French-Speaking Association of Endocrine Surgery (AFCE) using the Eurocrine® Database. Results: Over 11 years, 385 patients from 10 medical centres were eligible for analysis, accounting for >40% of adrenalectomies performed in France for primary aldosteronism over the period. Preoperative work-up was consistent with guidelines for 40% patients. Complete clinical success (CCS) at last follow-up was achieved in 32% patients and complete biological success was not sufficiently assessed. For patients with two follow-up visits, clinical results were not persistent at one year for 1/5 patients. Factors associated with CCS on multivariate analysis were body mass index, duration of hypertension and number of antihypertensive drugs. Conclusions: These results call for an improvement in thorough preoperative work-up and long-term follow-up of patients (clinical and biological) to early manage hypertension and/or PA relapse.

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