Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Endoscopic Thyroidectomy Via Areola Approach for Patients With Unilateral Papillary Thyroid Carcinoma

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Wei-Dong Zhang ◽  
Lei Dai ◽  
Ying-Chun Wang ◽  
Yun-Yun Xie ◽  
Jian-Yao Guo ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Endoscopic Thyroidectomy ◽  
Papillary Thyroid ◽  
Areola Approach ◽  
Vestibular Approach

Safety and Feasibility of the Transoral Endoscopic Thyroidectomy Vestibular Approach With Neuroprotection Techniques for Papillary Thyroid Carcinoma

2021 ◽  
Author(s):  
Zhen-Xin Chen ◽  
Ya-Min Song ◽  
Jing-Bao Chen ◽  
Xiao-Bo Zhang ◽  
Feng-Shun Pang ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Surgical Outcomes ◽  
Endoscopic Thyroidectomy ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Papillary Thyroid ◽  
Vestibular Approach

Abstract Background: This study aimed to evaluate the feasibility and safety of the trans-oral endoscopic thyroidectomy vestibular approach (TOETVA) with neuroprotection techniques for the surgical management of papillary thyroid carcinoma (PTC). Methods: Patients with PTC who underwent TOETVA between December 2016 and July 2020 were included in this study, and their relevant clinical characteristics, operational details, and surgical outcomes were reviewed and extracted from their medical records for further analysis. Results: A total of 75 patients successfully underwent TOETVA with zero conversions. Unilateral lobectomy with isthmectomy and total thyroidectomy were completed for 58 and 17 patients, respectively, all using our unique neuroprotective procedure and ipsilateral central neck dissection (CND). The mean number of retrieved lymph nodes versus positive lymph nodes was 6.8 ± 3.7 vs. 1.5 ± 2.3. Postoperative complications included three cases of transient superior laryngeal nerve (SLN) palsy (4.0%), five cases of transient recurrent laryngeal nerve (RLN) palsy (6.7%), 14 cases of transient hypoparathyroidism (18.7%), and two cases of lap perforation (2.7%). The follow-up period for patients with PTC lasted for 15.6 ± 10.9 months, during which no other complications or tumor recurrence were observed.Conclusion: TOETVA can be safely performed for patients with PTC with satisfactory results during the short-term follow-up period. Our neuroprotection techniques can be integrated into TOETVA, which is worth recommending for PTC patients who desire better cosmetic surgical outcomes.

scholarly journals Comparison of Conventional Open Thyroidectomy and Endoscopic Thyroidectomy via Breast Approach for Papillary Thyroid Carcinoma

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Zhuo Tan ◽  
JiaLei Gu ◽  
QianBo Han ◽  
WenDong Wang ◽  
KeJing Wang ◽  
...  
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Endoscopic Thyroidectomy ◽  
Patient Characteristics ◽  
Central Compartment ◽  
Clinical Results ◽  
Open Group ◽  
Papillary Thyroid ◽  
Open Thyroidectomy ◽  
Significant Difference

Purpose. The aim of this study was to evaluate the feasibility of endoscopic thyroidectomy via breast approach for papillary thyroid carcinoma (PTC).Methods. Between March 2008 and March 2013, 34 patients with PTC received endoscopic thyroidectomy (endo group) and 30 patients received conventional open thyroidectomy (open group). Patients in two groups underwent ipsilateral central compartment node dissection. The two groups were compared in terms of patient characteristics, perioperative clinical results, and postoperative complication.Results. The rates of lymph node metastasis in endo group and open group were 23.5% (8/34) and 13.3% (4/30), respectively, without statistically significant difference (P=0.351). The mean number of lymph nodes dissected was 2.4 ± 2.9 in endoscopic group and 2.2 ± 1.9 in open group (P=0.774). During the follow-up period, there was no recurrence or metastatic patients in two groups. All patients received the excellent cosmetic results in endo group, while 25 patients were satisfied with the cosmetic result and 5 were unsatisfied in the open group.Conclusions. The efficacy of endoscopic thyroidectomy via breast approach could be comparable to conventional open thyroidectomy in selected patients with PTC.

scholarly journals Safety of central compartment neck dissection for transoral endoscopic thyroid surgery in papillary thyroid carcinoma

2019 ◽  
Vol 50 (4) ◽  
pp. 387-391 ◽  
Author(s):  
Tiantian Wang ◽  
Yanping Wu ◽  
Qiuping Xie ◽  
Haichen Yan ◽  
Xiaoming Zhou ◽  
...  
Keyword(s):  
Lymph Node ◽  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Lymph Node Dissection ◽  
Central Compartment ◽  
Papillary Thyroid ◽  
Node Dissection ◽  
Visible Scar ◽  
Endoscopic Thyroid Surgery ◽  
Vestibular Approach

Abstract Background Remote access and endoscopic thyroid surgery has been gaining popularity because it allows patients to avoid a visible scar in the neck. There is limited data on transoral endoscopic thyroidectomy when it relates to patients with papillary thyroid carcinoma. We aim to evaluate the safety of ipsilateral central compartment dissection for patients who undergo transoral thyroidectomy (thyroidectomy vestibular approach–compartment lymph node dissection). Patients and Methods A total of 80 patients who underwent thyroidectomy vestibular approach–compartment lymph node dissection for papillary thyroid carcinoma from June 2015 to September 2016 were identified. Over the same period, a matched cohort of 80 patients who underwent open thyroidectomy with routine ipsilateral central compartment dissection was also identified (Open-compartment lymph node dissection). The two groups were analyzed in terms of patient characteristics, perioperative clinical results and post-operative outcomes. Results All patients were female with a mean age of 32-year. There was no difference in mean maximum tumor size and number of lymph nodes dissected. Moreover, there was no difference in average positive lymph nodes between thyroidectomy vestibular approach–compartment lymph node dissection and Open-compartment lymph node dissection (1.48 vs 1.08, P = 0.647). Operative time was longer in the thyroidectomy vestibular approach–compartment lymph node dissection group (193 vs 102 min, P < 0.001). Thyroidectomy specific complications were similar with rates of temporary recurrent laryngeal nerve palsy of 6.3 vs 8.8% and temporary hypocalcemia rates of 2.5 vs 5% in the thyroidectomy vestibular approach–compartment lymph node dissection and Open-compartment lymph node dissection groups, respectively. Conclusions Thyroidectomy vestibular approach–compartment lymph node dissection is a feasible and safe option for select patients with papillary thyroid carcinoma who require central node dissection compared with Open-compartment lymph node dissection, and can be a viable alternative for patients wishing to avoid a visible scar.

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