Comparison of Transoral Thyroidectomy Vestibular Approach and Unilateral Axillobreast Approach for Endoscopic Thyroidectomy: A Prospective Cohort Study

Nguyen, Hau Xuan; Nguyen, Long Thanh; Nguyen, Hung Van; Nguyen, Hanh H.; Trinh, Huy Le; Nguyen, Tuan Xuan; Le, Quang Van

doi:10.1089/lap.2020.0272

Cited by 18 publications

(10 citation statements)

References 35 publications

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“…Compared with Endoscopic Thyroidectomy Via a Unilateral Axillobreast Approach (UABA), TOETVA had lower VAS score in day 1, 4, and 7 postoperatively [27,28] because the flap dissection of TOETVA is less extensive than UABA and BABA techniques. In this study, the extreme satisfaction level of patients after TOETVA was 86.2%, which was explained by excellent cosmetic outcomes and painless postoperation.…”

Section: Discussionmentioning

confidence: 99%

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

Nguyen

Nguyễn

et al. 2021

Surg Endosc

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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. ResultsThe 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.

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Section: Discussionmentioning

confidence: 99%

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

Nguyen

Nguyễn

et al. 2021

Surg Endosc

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“…Patients were excluded if they did not agree in participating in the research or lost to follow-up at any time of the research period. The technique of the TOETVA procedure was described in our previous studies [ 10 , 11 , 13 ]. The flow chart of follow-up process was presented in Figure 1 .…”

Section: Methodsmentioning

confidence: 99%

“…Although it is proven that TOETVA is safe, feasible, and has invisible scarring, it is still an experimental technique with less data available regarding the patient's quality of life after surgery. At our center, Hanoi Medical University Hospital, TOETVA has been developed and applied since 2018, and it has proven the superior efficacy and patient satisfaction in comparison with other methods such as auxillary endoscopic thyroidectomy and open surgery [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life and Surgical Outcome of Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) versus Open Thyroid Surgery: Experience from a Single Center in Vietnam

Nguyen

Xuân

Hoang

et al. 2022

Journal of Thyroid Research

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Background. It has been widely assumed that TOETVA has demonstrated a new technique and a promising approach as it is both minimally invasive and optimally cosmetic. The objective of this study was to assess the surgical outcome, aesthetic satisfaction, and postoperative quality of life of TOETVA in comparison with open thyroid surgery. Patients and Methods. The study was designed as a prospective study, in which 121 patients from a single center in Vietnam underwent thyroid surgery, and the study was divided into two groups: 60 patients in the TOETVA group and 61 patients in the open surgery group. The patients have been followed up including surgical outcomes, cosmetic satisfaction, and quality of life. These criteria were assessed at 4 weeks, 8 weeks, and 12 weeks after the surgery using SF-36 and thyroid surgery-specific questionnaire. Results. Patients in the TOETVA group are significantly younger than patients in the open surgery group (35.8 + 10.3 vs 46.9 + 11.5, p < 0.001 ). The mean operating time was longer in the TOETVA group (102.9 ± 26.1 mins) than that in the open surgery group (66.8 ± 23.8 mins) with p = 0.0001 . Cosmetic outcomes and overall satisfaction were significantly greater in the TOETVA group p = 0.0001 . The SF-36 QOL scores of the patients in the TOETVA group were generally higher than the open surgery group. Conclusions. TOETVA has been widely used with a low complication rate, cosmetic appeal, and surgical efficacy. Postoperative quality of life, cosmetic outcomes, and overall satisfaction were significantly superior to the open surgery group.

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“…Neck appearance has an important influence on the quality of life (QoL) of TC patients. Endoscopic thyroidectomy and robotic thyroidectomy have been shown to be effective and safe surgical options for thyroid surgery while providing excellent cosmetic results ( 8 , 9 ). For patients who need lateral neck dissection (LND) due to metastatic lateral neck lymph nodes (LNs), a conspicuous scar (L-shaped, U-shaped, or extended collar) is often created, causing unsatisfactory experiences after the surgery.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Lateral Neck Dissection: A New Frontier in Endoscopic Thyroid Surgery

et al. 2021

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BackgroundEndoscopic thyroidectomy and robotic thyroidectomy are effective and safe surgical options for thyroid surgery, with excellent cosmetic outcomes. However, in regard to lateral neck dissection (LND), much effort is required to alleviate cervical disfigurement derived from a long incision. Technologic innovations have allowed for endoscopic LND, without the need for extended cervical incisions and providing access to remote sites, including axillary, chest–breast, face-lift, transoral, and hybrid approaches.MethodsA comprehensive review of published literature was performed using the search terms “lateral neck dissection”, “thyroid”, and “endoscopy OR endoscopic OR endoscope OR robotic” in PubMed.ResultsThis review provides an overview of the current knowledge regarding endoscopic LND, and it specifically addresses the following points: 1) the surgical procedure, 2) the indications and contraindications, 3) the complications and surgical outcomes, and 4) the technical advantages and limitations. Robotic LND, totally endoscopic LND, and endoscope-assisted LND are separately discussed.ConclusionsEndoscopic LND is a feasible and safe technique in terms of complete resection of the selected neck levels, complications, and cosmetic outcomes. However, it is recommended to strictly select criteria when expanding the population of eligible patients. A formal indication for endoscopic LND has not yet been established. Thus, a well-designed, multicenter study with a large cohort is necessary to confirm the feasibility, long-term outcomes, oncological safety, and influence of endoscopic LND on patient quality of life (QoL).

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Comparison of Transoral Thyroidectomy Vestibular Approach and Unilateral Axillobreast Approach for Endoscopic Thyroidectomy: A Prospective Cohort Study

Cited by 18 publications

References 35 publications

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

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

Quality of Life and Surgical Outcome of Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) versus Open Thyroid Surgery: Experience from a Single Center in Vietnam

Endoscopic Lateral Neck Dissection: A New Frontier in Endoscopic Thyroid Surgery

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