Transoral endoscopic surgery for papillary thyroid carcinoma: initial experiences of a single surgeon in South Korea

Yi, Jin Wook; Yoon, Sang Gab; Kim, Hyun Soo; Yu, Hyeong Won; Kim, Sujin; Chai, Young Jun; Choi, June Young; Lee, Kyu Eun

doi:10.4174/astr.2018.95.2.73

Cited by 40 publications

(23 citation statements)

References 28 publications

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“…A sufficient number of studies have already been published but long-term follow-up results of TOETVA regarding its surgical and oncologic safety are lacking (16)(17)(18). Although preliminary case series report favorable outcomes (19) and shorter learning curves compared to other minimal invasive surgery (MIS) procedures (20), clear and robust data supporting safety issues and a non-inferiority identity compared to conventional thyroidectomy are still pending (4,21,22 pioneers, agree on the critical need for adequate training and prevention of novel complications.…”

Section: Discussionmentioning

confidence: 99%

Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review

Akritidou¹,

Douridas²,

Spartalis

et al. 2021

In Vivo

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This review focuses on complications linked to trans-oral endoscopic thyroidectomy via vestibular approach (TOETVA) and aimed to elucidate the procedure's initial safety profile. According to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), Pubmed, Embase, and the Cochrane databases were screened till May 2021. Twenty-eight articles, nine cohorts and nineteen case series, met the inclusion criteria. Procedure-related complications were analyzed, the most important being hypoparathyroidism: transient (range=0.94-22.2%), permanent (range=1.33-2.22%), and recurrent laryngeal nerve injury: transient (range=1.9-8.8%) and permanent (range=0.59-1.42%). Surgical trauma related complications, the most prevalent being seroma, emphysema, and hematoma accounted for 2.91%. Null mortality was reported. Although current evolving experience indicates that TOETVA is safe and linked to acceptable complication rates, the method needs to be compared with the gold standard of traditional thyroidectomy in the context of sufficiently numbered cohorts and ultimately randomized controlled trials.

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Section: Discussionmentioning

confidence: 99%

Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review

Akritidou¹,

Douridas²,

Spartalis

et al. 2021

In Vivo

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“…Third, transoral endoscopic thyroidectomy (TOET) has received attention in recent years, but no reports have compared OT with TOET in total thyroid cancer. Most patients who undergo TOET have benign lesions,44 and many reports are on initial experiences45,46 or robot-assisted surgery 47,48. In addition, cosmetic results and quality of life are difficult to assess because of the few well-accepted tools available to study such outcomes 40…”

Section: Discussionmentioning

confidence: 99%

Total endoscopic thyroidectomy versus conventional open thyroidectomy in thyroid cancer: a systematic review and meta-analysis

Chen¹,

Huang²,

Jia³

et al. 2018

TCRM

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BackgroundDespite the considerable experience gained thus far using endoscopic technologies, the role of total endoscopic thyroidectomy (ET) for papillary thyroid cancer (PTC) remains controversial. We conducted a systematic review and meta-analysis to investigate the safety and effectiveness of total ET compared with conventional open thyroidectomy (OT) in PTC.MethodsA systematic search was conducted using the PubMed, Embase and Cochrane Library electronic databases up to March 2018. The quality of included studies was evaluated using the Newcastle–Ottawa Scale. Review Manager software version 5.3 was used for the meta-analysis.ResultsTwelve studies including 2,672 patients were ultimately included in the systematic review and meta-analysis. ET was associated with longer operative time (P<0.00001), drainage time (P<0.00001) and hospital stay (P=0.03), higher transient recurrent laryngeal nerve (RLN) palsy rate (P=0.004) and a greater amount of drainage fluid (P<0.0001) compared with OT. Furthermore, no significant differences were detected between ET and OT in terms of retrieved lymph nodes (P=0.17), blood loss (P=0.22), transient hypocalcemia (P=0.84), permanent hypocalcemia (P=0.58), permanent RLN palsy (P=0.14), hematoma or bleeding (P=0.15) and seroma (P=0.54). In addition, the rates of tumor recurrence were comparable (P=0.18), whereas the proportions of stimulated thyroglobulin levels <1 ng/mL measured after completion of thyroidectomy and radioactive iodine therapy were less (P=0.02) in the ET than in the OT group.ConclusionET is not superior to OT in terms of operation and drainage time, amount of drainage fluid, hospital stay or transient RLN palsy, but is comparable to OT in terms of retrieved lymph nodes and permanent complications. Despite the similar tumor recurrence rates between the two approaches, the level of surgical completeness in ET may not be as good as that for OT.

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“…SSI can develop into abscesses, and systemic infection such as sepsis can develop in severe cases. Reports show very low infection rates following a regimen of perioperative intravenous antibiotics (amoxicillin–clavulanic acid 1.2 g or oxacephem 1 g) for 1–2 days, followed by oral antibiotics for 3–7 days post surgery [ 3 , 16 , 30 , 31 ]. In the current study, to prevent SSI, preoperative antibiotic prophylaxis (Cefotetan 1 g) was administered once, and the oral cavity was carefully prepared.…”

Section: Discussionmentioning

confidence: 99%

Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Surgical Outcomes and Learning Curve

Chai

Chae

et al. 2021

JCM

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The transoral endoscopic thyroidectomy vestibular approach (TOETVA) has excellent cosmetic effects and its popularity is increasing worldwide. We present our experience with TOETVA and its short-term outcomes. This study included 110 consecutive patients who underwent TOETVA at a single institution between July 2016 and June 2020. We analyzed clinicopathologic data, short-term postoperative outcomes, and learning curve using cumulative summation (CUSUM) analysis. Of the 110 patients who underwent TOETVA, 101 had malignant disease and 100 (90.9%) underwent lobectomy. The mean age was 39.7 ± 9.7 years, and the mean tumor size was 1.0 ± 0.7 cm (range, 0.3–3.6 cm). Operation time was 168.0 ± 63.4 min for total thyroidectomy, 111.0 ± 27.7 min for lobectomy, and 73.7 ± 18.1 min for isthmusectomy. Five patients (4.5%) experienced transient vocal cord palsy (VCP) and one (0.9%) had permanent VCP. The swallowing impairment index-6 score was 2.18 ± 3.21 at postoperative three months, and 0.97 ± 1.72 at postoperative six months. The learning curve for lobectomy was 58 cases in CUSUM analysis. TOETVA is a safe and feasible approach with an acceptable operation time and a low complication rate. This approach is a surgical option for patients who desire excellent cosmesis.

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Transoral endoscopic surgery for papillary thyroid carcinoma: initial experiences of a single surgeon in South Korea

Cited by 40 publications

References 28 publications

Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review

Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review

Total endoscopic thyroidectomy versus conventional open thyroidectomy in thyroid cancer: a systematic review and meta-analysis

Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Surgical Outcomes and Learning Curve

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