Transoral Endoscopic Thyroidectomy for Thyroid Cancer

Jongekkasit, Isariya; Jitpratoom, Pornpeera; Sasanakietkul, Thanyawat; Anuwong, Angkoon

doi:10.1016/j.ecl.2018.11.009

Cited by 67 publications

(49 citation statements)

References 37 publications

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“…Until now, the transoral approach was reported to effectively treat thyroid cancer and benign tumors. [6][7][8] The difference between TOETVA and chest approach endoscopic thyroid treatment has not been reported to date. In our article, we aim to analyze the treatment of patients undergoing either the areola breast approach or the transoral vestibular approach to explore the clinical efficacy and safety of the two approaches.…”

Section: Introductionmentioning

confidence: 99%

Comparative Study Between Endoscopic Thyroid Surgery via the Oral Vestibular Approach and the Areola Approach

Guo

Wang

Zhu

et al. 2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Objective: To investigate the clinical efficacy and safety of endoscopic thyroidectomy through the oral vestibular approach and the breast approach. Methods: Retrospective analysis was done on clinical data of 80 patients who received an endoscopic thyroidectomy from April 2018 to March 2019. The research group had endoscopic thyroidectomy through the oral vestibular approach, whereas the control group had endoscopic thyroidectomy through the areola breast approach. Comparison between the two groups including intraoperative bleeding, operation time, total postoperative drainage, drainage time, postoperative sustained pain time, recovery feeding time, postoperative hospitalization duration, satisfactory esthetic outcomes of incision, central lymph node clearance, skin injury, infection incidence, and complications such as facial hematoma, subcutaneous emphysema, abnormal feeling of the neck and chest, and pleural injury was recorded. Results: There was no significant difference between the two groups in the amount of intraoperative bleeding, operation time, total postoperative drainage, drainage time, postoperative sustained pain time, recovery feeding time, and postoperative hospitalization time (P > .05). The incidence of complications such as skin injury, infection, wound hematoma, subcutaneous emphysema, abnormal feeling of the neck and chest, and pleural injury was not statistically different between the two groups (P > .05). There was no significant difference in the number of lymph nodes cleaned in the central area between the two groups (P > .05). The overall satisfaction of the patients with the cosmetic effects of the incision (100.00%) was higher than that of the control group (90.00%). Conclusions:The clinical treatment effect and safety in the two groups were similar, but the transoral group had better cosmetic effects.

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Section: Introductionmentioning

confidence: 99%

Comparative Study Between Endoscopic Thyroid Surgery via the Oral Vestibular Approach and the Areola Approach

Guo

Wang

Zhu

et al. 2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Remote-access thyroid surgery is employed to bypass the neck scar resulting from traditional thyroid surgery with transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) being the most recent and the only scarless surgery. 4 , 5 , 6 , 7 , 8 …”

Section: Introductionmentioning

confidence: 99%

Completion thyroidectomy: is timing important for transcervical and remote access approaches?

Dueñas

Duque

Cristancho³

et al. 2020

World j. otorhinolaryngol.-head neck surg.

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Completion thyroidectomy (CT) is employed after lobectomy when histopathological results mandates total removal of the gland as in case of well differentiated thyroid carcinoma (DTC). It is also employed as a second stage thyroid surgery when unfavorable events occur as in recurrent laryngeal nerve injury or when the surgeon finds out the case is beyond his/her expertise in an attempt to protect the contralateral side and allowing time for recovery or for an expert surgeon to help.

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“…19 Of the various transoral approaches to the thyroid, the transoral vestibular approach is the most cited in the literature and has been shown to have good surgical outcomes with the least complications in Western populations. 20 First described by Richmon and colleagues, 21 the transoral vestibular approach offers several technical advantages over other remote-access neck surgeries. Namely, the transoral route is the most direct and shortest of the extra-cervical routes to the thyroid while still allowing bilateral access; it only requires a small amount of flap dissection; and, it has a relatively short learning curve compared to the other methods.…”

Section: Discussionmentioning

confidence: 99%

Transoral neck surgery prevents attentional bias towards the neck compared to open neck surgery

et al. 2019

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Objective: Measure attentional distraction of neck scars after open neck surgery compared to transoral endoscopic thyroidectomy via a vestibular approach (TOETVA) or transoral endoscopic parathyroidectomy via a vestibular approach (TOEPVA) using eye-tracking technology.Methods: Casual observers viewed facial images of patients who underwent open neck surgery, TOETVA/TOEPVA, or no surgery (controls). An eye-tracking monitor recorded eye fixations in real time. Multivariate Hotelling's analysis followed by post-hypothesis testing compared fixation durations for predefined regions of interest, including the eyes, nose, mouth, neck, and remaining face between open neck surgery patients, transoral neck surgery patients, and controls.Results: One hundred forty observers completed the experiment. The majority of their attention was directed towards the central triangle (eyes, nose, mouth). On multivariate analysis, distribution of attention was significantly different on the faces of those who underwent open neck surgery versus TOETVA/TOEPVA (T 2 = 43.66; F[32,131] = 14.5389, P < .0001). Observers attended significantly more to the neck (0.20 seconds, P < .0001; 95% CI, 0.13, 0.26 s) and less to the peripheral face (−0.24 seconds, P = .0031; 95% CI, −0.39, −0.08 s) of open neck surgery patients. In patients who followed up months after surgery, significant differences persisted (T 2 = 13.97; F[3451] = 4.6377, P = .0033). By contrast, fixation patterns for TOETVA/TOEPVA patients were not significantly different from controls (T 2 = 5.59, F[31,186] = 1.8602, P = .1345). Observer race and gender did not significantly affect attention to neck scars.Conclusion: Scars following open neck surgery draw attention in casual observers. This attentional distraction is prevented in TOETVA/TOEPVA patients due to the absence of a scar, even months after surgery. Moreover, visual processing of TOETVA/TOEPVA patients' faces is similar to that of controls. These data support the effectiveness of transoral neck surgery in giving patients a cosmetic result that does not distract the attention of observers.

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Transoral Endoscopic Thyroidectomy for Thyroid Cancer

Cited by 67 publications

References 37 publications

Comparative Study Between Endoscopic Thyroid Surgery via the Oral Vestibular Approach and the Areola Approach

Comparative Study Between Endoscopic Thyroid Surgery via the Oral Vestibular Approach and the Areola Approach

Completion thyroidectomy: is timing important for transcervical and remote access approaches?

Transoral neck surgery prevents attentional bias towards the neck compared to open neck surgery

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