Outcome of Transoral Endoscopic Thyroidectomy Vestibular Approach (Toetva) in Comparison With Open Thyroidectomy for Benign Thyroid Nodules

Abstract

Open thyroidectomy; is the gold standard surgical procedure for thyroid diseases, but the incision scar in the anterior aspect of the neck due to this approach cannot be avoided and may results in a permanent cosmetic defect. Therefore, there is a need to improve postoperative quality of life, including cosmetics. Recently, transoral endoscopic thyroidectomy has been developed; it is a natural orifice thyroid surgery, minimally invasive and completely scar free. This study aimed to describe the outcome, patient's satisfaction, and complications after hemithyroidectomy for benign thyroid nodules by transoral endoscopic vestibular approach in comparison with open approach. This study was conducted in Al-Shiffa General hospital, Basrah, Iraq from August 2017 to June 2019 and was approved by a local ethical committee. Fifty patients with benign thyroid nodules who are candidate for hemithyroidectomy were included in the study; they were divided into two groups according to the method for thyroidectomy which was either conventional open or transoral endoscopic thyroidectomy vestibular approach based on the patients' preferences. All operations were performed by the same surgical team. The results of this study showed that 24 (48%) of them operated upon by transoral endoscopic thyroidectomy vestibular approach, while the remaining 26 (52%) patients have been operated upon by open thyroidectomy approach. Transoral endoscopic thyroidectomy vestibular approach reported significant longer operative time, has comparable rate of complications with an excellent cosmetic outcome and better postoperative patients' satisfaction in comparison to open thyroidectomy. In conclusion, transoral endoscopic thyroidectomy vestibular approach is a safe and feasible procedure with an excellent cosmetic outcome and better patients' satisfaction. At present, it is a relatively time-consuming procedure and, therefore, candidate patients with a strong motivation for scar free surgery are recommended.