Comparison of Different Mandibular Jawlines Classifications on Transoral Endoscopic Thyroidectomy for Papillary Thyroid Carcinoma: Experiences of 690 Cases

Xing, Yu; Jiang, Yiqun; Li, Yujun; He, Qionghua; Pan, Lei; Zhu, Ping; Wang, Yong; Wang, Ping

doi:10.3389/fendo.2022.842148

Cited by 6 publications

(7 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nine patients (2.0%) in our study developed transient RLN injury, with no significant difference between the groups; however, none of the patients developed permanent RLN injury in either group. Studies have shown post-TOETVA incidence to be 0.5%-5.9% and 0%-2.3% for transient and permanent RLN injuries, respectively (11,19,23,24). All cases of RLN injury in previous studies were unilateral; to the best of our knowledge, there are no reports of bilateral RLN injury after TOETVA.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The ambulatory transoral endoscopic thyroidectomy vestibular approach is safe and economical for patients with thyroid nodules

Sun

Chu²,

Zhang³

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundAmbulatory thyroid surgery has been increasingly performed in recent years. However, the feasibility of the ambulatory transoral endoscopic thyroidectomy vestibular approach (TOETVA) has not been evaluated. We aimed to evaluate the safety, economy, and mental health outcomes of ambulatory TOETVA.MethodsWe retrospectively reviewed the data of patients who underwent TOETVA between March 2019 and August 2022. The procedure was performed by a skilled surgical team from the Department of Thyroid Surgery of the affiliated Yantai Yuhuangding Hospital of Qingdao University. Patients were enrolled in the ambulatory (n=166) and conventional (n=290) groups, based on their chosen procedure. We analyzed patients’ clinical characteristics, surgical outcomes, Hamilton Anxiety Rating Scale (HAM-A) scores, and hospitalization costs.ResultsOf 456 patients, 166 underwent ambulatory TOETVA and 290 underwent conventional TOETVA. No significant differences were found in clinical and surgical characteristics between the groups, including sex (P=0.363), age (P=0.077), body mass index (P=0.351), presence of internal diseases (P=0.613), presence of Hashimoto’s thyroiditis (P=0.429), pathology (P=0.362), maximum tumor diameter (P=0.520), scope of surgery (P=0.850), or operative time (P=0.351). There were no significant differences in maximum tumor diameter (P=0.349), extrathyroidal tissue invasion (P=0.516), number of retrieved central lymph nodes (P=0.069), or metastatic central lymph nodes (P=0.897) between the groups. No significant differences were found in complications, including transient hypoparathyroidism (P=0.438), transient vocal cord palsy (P=0.876), transient mental nerve injury (P=0.749), permanent mental nerve injury (P=0.926), and other complications (P=1.000). Ambulatory patients had shorter hospital stays (P<0.001) and reduced hospitalization costs (P<0.001). There was no significant difference in HAM-A scores between the groups (P=0.056).ConclusionsAmbulatory TOETVA is a safe, feasible, and cost-effective procedure for selected patients. This procedure resulted in shorter hospital stays, decreased medical costs, and did not increase patient anxiety. To ensure patient safety, surgical teams must inform patients of the indications, when to seek help, and how to receive the fastest medical attention.

show abstract

Section: Discussionmentioning

confidence: 99%

“…patients in the ambulatory group had shorter hospital stays (1.08 ± 1.01 days vs. 3.41 ± 0.62 days, P < 0.001) and lower hospitalization cost(23,894.47 ± 3298.43 yuan vs. 25,474.30 ± 2686.54 yuan, P < 0.001). The two groups had no…”

mentioning

confidence: 93%

The ambulatory transoral endoscopic thyroidectomy vestibular approach is safe and economical for patients with thyroid nodules

Sun

Chu²,

Zhang³

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…This excessive pressure increased the risk of cannula fractures. This may also explain why patients with a prominent mandibular jawline have more postoperative swelling and perceive more pain after TOETVA [13]. Table 3 summarizes the proposed strategies for preventing cannula fractures.…”

Section: Discussionmentioning

confidence: 99%

“…It is more difficult for a small chin to accommodate a standard 12 mm port; thus, a small chin may be a predisposing factor for cannula fracture. In addition, Case 3 had a protruding chin and the distance between the jaw and neck (length of jaw) was greater, even with the neck extended ( Figure 4 ) [ 13 ]. Greater force had to be applied to tilt the central cannula, which introduced the endoscope, downwards to visualize the operative field properly.…”

Section: Discussionmentioning

confidence: 99%

Cannula Fracture during Transoral Endoscopic Thyroidectomy Vestibular Approach: Causes and Prevention

2022

View full text Add to dashboard Cite

In the transoral endoscopic thyroidectomy vestibular approach (TOETVA), three oral vestibular incisions are used to access the thyroid. This approach leaves no scar on the body surface; however, unexpected complications may occur. Three patients (two women, one man) underwent TOETVA using the standard three-port technique. Broken cannulas of the 12 mm central port were noted in all cases. All cannulas broke on the ventral side of the distal shaft. The fracture lines were 3–4 cm in length, with some fragments scattered throughout the operative field and oral cavity. The fractures were caused by compression against the mandible while tilting the cannula during surgical manipulation. Male sex, short stature, and protruding chin may be risk factors for cannula fracture in TOETVA. Measures should be taken to prevent this complication, particularly in high-risk patients.

show abstract

“…The Thyroid Cancer-Speci c Quality of Life Questionnaire (THYCA-QOL) highlighted concerned with scarring, and a history of minimally invasive thyroid surgery was found to be associated with better thyroid cancer-speci c QOL [3]. In the quest for better cosmetic results, various endoscopic thyroid surgery approaches have been introduced, with the bilateral areola approach showing promise and being recommended, especially in lymph node dissection [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and safety of modified en bloc resection in endoscopic thyroid surgery via bilateral areolar approach – Long-term institutional analysis 10 years after surgery

Xie,

Ma,

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

Purpose This study aimed to introduce a new method of modified en bloc resection, evaluate its feasibility and safety in endoscopic thyroid surgery via bilateral areolar approach (BAA). Methods 108 and 213 papillary thyroid carcinoma (PTC) patients underwent lobectomy + ipsilateral central node dissection (CND) with modified en bloc method and conventional method via BAA were included in this study, and the patients were follow-up for an average of 10 years. The main outcomes including operative duration, lymph nodes yield (LNY), surgical complications, and the rate of recurrence and metastasis. Results There was no significant difference in terms of gender, age, tumor locations, tumor dominant nodule size, and the incidence concomitant Hashimoto thyroiditis in the clinicopathologic characteristics comparison. It was similar in the comparison of operative duration (P = 0.14), blood loss (P = 0.13), postoperative hospital stay (P = 0.58), incidence of transient vocal cord paralysis (P = 0.90) and hypocalcemia (P = 0.60). While the mean LNY achieved in the central compartment of Modified en bloc Group (7.5 ± 4.5) was significant more than it in Conventional Group (5.6 ± 3.6). Two patients in the Modified en bloc group and two patients in the Conventional group were found metastasis after surgery in the average 10 years follow up (1.8% vs. 0.9%, P = 0.60). In the analysis of learning curve, the operative duration of modified en bloc resection was significantly decreased from the 25-35th cases. Conclusions The method of modified en bloc resection in endoscopic thyroid surgery via BAA seems to be a technically feasible and safe procedure with excellent cosmetic results for selective PTC patients.

show abstract

Comparison of Different Mandibular Jawlines Classifications on Transoral Endoscopic Thyroidectomy for Papillary Thyroid Carcinoma: Experiences of 690 Cases

Cited by 6 publications

References 18 publications

The ambulatory transoral endoscopic thyroidectomy vestibular approach is safe and economical for patients with thyroid nodules

The ambulatory transoral endoscopic thyroidectomy vestibular approach is safe and economical for patients with thyroid nodules

Cannula Fracture during Transoral Endoscopic Thyroidectomy Vestibular Approach: Causes and Prevention

Feasibility and safety of modified en bloc resection in endoscopic thyroid surgery via bilateral areolar approach – Long-term institutional analysis 10 years after surgery

Contact Info

Product

Resources

About