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Surgical Endoscopy

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01-02-2020 | Hypoparathyroidism

Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases

Authors: Jong-hyuk Ahn, Jin Wook Yi

Published in: Surgical Endoscopy | Issue 2/2020

Abstract

Background

Transoral endoscopic thyroid surgery vestibular approach (TOETVA) is a promising technique involving no skin incision. Since its first use in 60 patients in 2015, TOETVA has been adopted by several hospitals worldwide. However, reports of TOETVA for thyroid cancer are scarce.

Methods

Between August 2016 and March 2019, 150 and 125 thyroid cancer patients underwent TOETVA and open thyroidectomy (OT), respectively, by a single endocrine surgeon. Comparative analyses were performed on clinical and pathological findings, complications, and surgical completeness in total thyroidectomy cases, as indicated by the serum thyroglobulin (Tg) level. Data were collected prospectively and analyzed retrospectively.

Results

Mean age was younger in the TOETVA than in the OT group (43.06 ± 10.90 vs. 51.02 ± 12.42). The percentage of females was 96.7% in the TOETVA group. Total thyroidectomy was higher in the OT group (26.7% vs. 65.0%). Operation time (min) was longer in the TOETVA group for lobectomy (102.12 ± 32.59 vs. 76.38 ± 21.24) and total thyroidectomy (132.65 ± 34.79 vs. 90.71 ± 25.09). The largest tumor diameter was 0.91 (± 1.00) in the TOETVA group and 1.19 (± 1.07) in the OT group. The harvested lymph node number was not significantly different between the two groups for lobectomy (3.19 ± 2.89 vs. 3.49 ± 2.41, p = 0.319) and total thyroidectomy (4.98 ± 3.12 vs. 5.70 ± 4.35, p = 0.714). The thyroid-stimulating hormone stimulated Tg level before administration of the first dose of radioactive iodine was also not different (3.38 ± 10.87 vs. 3.44 ± 11.51, p = 0.595). Percentage of stimulated Tg below 1.0 ng/ml was 80.0% in the TOETVA group.

Conclusions

TOETVA is feasible in selected thyroid cancer patients, not only because it is cosmetically advantageous but also because it is oncologically safe. A large prospective cohort study including recurrence surveillance is needed to consolidate the feasibility of TOETVA.

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Title: Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases
Authors: Jong-hyuk Ahn
Jin Wook Yi
Publication date: 01-02-2020
Publisher: Springer US
Keywords: Hypoparathyroidism
Thyroidectomy
Thyroidectomy
Thyroid Cancer
Thyroid Cancer
Thyroid Cancer
Published in: Surgical Endoscopy / Issue 2/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06841-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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