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

Abstract

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.

A comparison of swallowing related quality of life in patients undergoing transoral endoscopic versus open thyroid surgery

“…Only two previous studies have utilized a questionnaire having a component on swallowing related dysfunction after thyroid surgery. Nguyen et al 8 22 used SF-12 and a self-developed thyroid surgery questionnaire which had a single question on dysphagia (Have you had any swallowing difficulties?). Authors reported no difference in this domain between TOETVA and OTx at the end of 6 weeks.…”

“…Only two previous studies have utilized a questionnaire having a component on swallowing related dysfunction after thyroid surgery. Nguyen et al 8 . reported that TOETVA was superior to open surgery in terms of postoperative quality of life, patient satisfaction, and cosmetic outcomes.…”

“…5,6 As the TOETVA is rapidly being adopted, multiple studies focusing on the quality of life between TOETVA and OTx have been published recently showing superior outcomes with TOETVA. [7][8][9][10][11] Dysphagia after thyroid surgery is considered transient, mostly requiring reassurance but sometimes may require swallow therapy. However, swallowing dysfunction has been reported to negatively affect the swallowing related quality of life (SWAL-QoL) after OTx.…”

“…The safety and outcomes of Transoral endoscopic thyroidectomy vestibular approach (TOETVA) in comparison to conventional/open surgery has been well established 5,6 . As the TOETVA is rapidly being adopted, multiple studies focusing on the quality of life between TOETVA and OTx have been published recently showing superior outcomes with TOETVA 7–11 …”

Comparison of surgical outcomes of transoral robotic and endoscopic thyroidectomy: A systematic review and network meta‐analysis

“…Seventeen studies, 8,10,34,[37][38][39][40][41][42][43][44][45][46][48][49][50][51] including 2866 patients, reported data of postoperative pain and hospital stay (Figure 2E,F). The mean pain score varied from 2.08 to 3.76 in the TOETVA group, 1.67 to 3.13 in the TORT group, and 1.67 to 4.90 in the CTT group.…”