Original Article
Preliminary experience with transoral endoscopic thyroidectomy via vestibular approach: a report of 150 cases in a single center
Yong Wang, Qiuping Xie, Xing Yu, Cheng Xiang, Maolin Zhang, Qunzi Zhao, Haichao Yan, Ping Wang, Shaoming Xu
Published 2017-08-01
Cite as Chin J Surg, 2017, 55(8): 587-591. DOI: 10.3760/cma.j.issn.0529-5815.2017.08.007
Abstract
ObjectiveTo summarize the preliminary experience with transoral endoscopic thyroidectomy via vestibular approach (TOETVA).
MethodsA total of 150 consecutive patients with thyroid disease underwent TOETVA from November 2014 to February 2017 at Department of Thyroid Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine. The patients were comprised of 138 females and 12 males. The mean age of the patients was (31.7±7.6) years (ranging from 15 to 51 years). There were 108 patients of differential thyroid carcinoma (T1 or T2 ≤3 cm, cN0 or cN1a, M0) and 42 patients of benign thyroid disease (solid nodule ≤6 cm). The criteria analyzed were clinicopathologic characteristics, types of operation, operation time, complications and results of follow-up.
ResultsTwo cases were converted into open surgery due to an incredible unexpected tumor size and tracheal invasion, respectively. One hundred and three patients with papillary carcinoma underwent transoral central neck dissection (CND), with the mean operation time of (146±34) minutes for hemithyroidectomy with CND, and (187±36) minutes for total or near total thyroidectomy with CND. The mean number of lymph node yields was 8.2±4.7, and the lymph node metastasis rate was 41.7% (43/103). Regarding postoperative complications, transient hoarseness occurred in 3 patients, and permanent recurrent laryngeal nerve occurred in 2 patients. One patient had local infection or transient mental nerve palsy. Transient hypocalcemia occurred in 31.8% of 22 patients who underwent total, near-total, or subtotalthyroidectomy, and no permanent hypocalcemia was registered. Mean hospital stay after operation was (3.5±0.6) days (ranging from 2 to 5 days). Mean follow-up period was (11.5±7.8) months (ranging from 1 to 28 months), no recurrence or metastasis occurred.
ConclusionsTOETVA is feasible and safe for strictly selective patients. It brings perfect cosmetic effect. Long-term follow-up and further study is needed to assess its curative effect.
Key words:
Thyroid diseases; Mouth; Endoscopy; Thyroidectomy; Neck dissection
Contributor Information
Yong Wang
Department of Thyroid Surgery, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
Qiuping Xie
Xing Yu
Cheng Xiang
Maolin Zhang
Qunzi Zhao
Haichao Yan
Ping Wang
Shaoming Xu
