Remote Access Thyroid Surgery: A Review of Literature

Kudpaje, Akshay; Subash, Anand; Subramaniam, Narayana; Us, Vishal Rao; Arakeri, Gururaj

doi:10.1007/s13193-021-01364-y

Cited by 10 publications

(7 citation statements)

References 55 publications

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“…The costs include having to rely heavily on energy-based devices for extensive tissue dissection, which poses greater challenges to operators. Besides, as with other remote access thyroid surgeries, GTET has failed to gain widespread acceptance in the surgical community because of the technical challenges, scepticism about oncological safety, and cost factors [ 47 ]. On the contrary, it is actually more invasive.…”

Section: Discussionmentioning

confidence: 99%

Surgical Steps of Gasless Transaxillary Endoscopic Thyroidectomy: From A to Z

Yang

Guo

et al. 2022

Journal of Oncology

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In the past 30 years, the incidence of differentiated thyroid cancer (DTC) has been increasing rapidly and has become one of the most common malignant tumors in females. Currently, the main surgical treatment for DTC is standard open thyroidectomy (SOT) via a traditional Kocher mid-cervical incision, but postoperative neck scarring was associated with significantly worse health-related quality of life (HRQOL) scores. To offer better cosmesis, robotic/endoscopic thyroidectomy via cervical, axillary, anterior chest, breast, postauricular, or transoral approaches have been developed over the past 20 years. In general, gasless transaxillary endoscopic thyroidectomy (GTET) has advantages in terms of convenience, clarity of vision, and aesthetic incision. The current work aims to provide a step-by-step description of GTET, supported by a high-quality, pictorial guide.

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Section: Discussionmentioning

confidence: 99%

Surgical Steps of Gasless Transaxillary Endoscopic Thyroidectomy: From A to Z

Yang

Guo

et al. 2022

Journal of Oncology

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“…Over the past few decades, various alternative approaches, categorized as “remote access,” have emerged to minimize visible cervical scarring. These approaches include the trans-axillary approach, transoral/vestibular approach, retro-auricular approach, transareola approach, bilateral axillo-breast approach (BABA), subclavian approach, and others [ 3 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Advances in the assessment of cosmetic outcomes, sensory alteration in surgical areas, and health-related quality of life of endoscopic thyroidectomy

Zhou,

Zhang,

Dou

et al. 2024

World J Surg Onc

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Background Endoscopic thyroidectomy has been preliminarily proven effective and safe for thyroid diseases. The cosmetic outcomes and life quality are critical contents of postoperative assessment. This review will primarily focus on the assessment methods and results related to cosmetic outcomes, sensory alteration of surgical area, and quality of life following endoscopic thyroidectomy. Methods A comprehensive search of published articles within the last decade was conducted using the terms “endoscopic/robotic thyroidectomy,” “patient satisfaction scores,” “questionnaire,” “quality of life,” and “cosmetic” in PubMed. Results Assessment methods for postoperative cosmetic satisfaction and sensory alterations encompassed verbal/visual analog scales, scar evaluations, Semmes–Weinstein monofilament tests, and more. The evaluation of postoperative quality of life in endoscopic thyroidectomy involved tools such as SF-36, SF-12, thyroid-specific questionnaires, thyroid cancer-specific quality of life questionnaires (THYCA-QOL), as well as assessments related to voice and swallow function. The cosmetic results of endoscopic thyroidectomy generally surpassed those of open thyroidectomy, while the quality of life in endoscopic procedures was either superior or equivalent to that in open thyroidectomy, especially with respect to general health, role emotion, and vitality. Conclusions Assessments of cosmetic outcomes and sensory alterations following endoscopic thyroidectomy predominantly relied on patients’ subjective feelings. The objective and subjective perspectives of scar assessments remain underutilized. In addition, postoperative laryngoscopy and voice function assessments in endoscopic thyroidectomy procedures require more attention.

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“…Endoscopic surgeries, while typically associated with reduced scarring and fewer complications, can, in certain circumstances, present unique challenges. For example, the use of unconventional entry sites can increase the risk of injury to critical nerves, such as brachial plexus injury with the axillary approach ( 3 ), or central nerve palsy with the transoral approach can lead to central nerve palsy ( 4 ). In light of these nuances and the potential variability in outcomes, a comprehensive evaluation of the efficacy and safety of endoscopic thyroid surgery is imperative.…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes of endoscopic thyroidectomy approaches for thyroid cancer: a systematic review and network meta-analysis

Li,

Ding,

Zhang

2023

Front. Endocrinol.

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ObjectivesThis network meta-analysis assesses the outcomes of seven endoscopic approaches, offering valuable insights for researchers and practitioners in choosing the best method for thyroid cancer patients.MethodsA systematic literature search was conducted in the PubMed, Embase and Web of Science databases up to March 2023. The analysis included seven endoscopic approaches, with a focus on their respective outcomes through network meta-analysis.ResultsThis meta-analysis included 44 studies involving 8,672 patients. The axillo-bilateral breast approach (ABBA) and unilateral axillo-breast approach (UABA) showed advantages in terms of reduced operative time compared to other approaches (MD = 19.66 minutes, 95% CI = -31.66 to 70.98; MD = 30.32 minutes, 95% CI = -1.45 to 62.09, respectively). The UABA and anterior chest approach (ACA) exhibited superiority in controlling intraoperative bleeding (MD = -3.37 mL, 95% CI = -22.58 to 15.85; MD = -13.77 mL, 95% CI = -28.85 1.31, respectively). UABA and ACA also showed advantages in reducing hospital stays (MD = -0.39 days, 95% CI = -1.48 to 0.71; MD = -0.26 days, 95% CI = -1.33 to 0.81, respectively). The transoral approach (OA) yielded results comparable to those of conventional open thyroidectomy (COT) and outperformed other endoscopic surgeries with regards to lymph node retrieval and metastatic lymph node assessment. For the stimulated serum thyroglobulin (TG) levels, no significant difference was observed between bilateral axillo-breast approach (BABA) and OA compared to COT. However, chest-breast approach (CBA) showed significantly lower levels than COT (MD=-0.40 ng/ml, 95% CI =-0.72 to -0.09). Patients in the gasless unilateral transaxillary approach (GUA) group experienced a significant improvement in cosmetic satisfaction (MD=-2.08, 95% CI =-3.35 to -0.82). Importantly, no significant difference was observed in the incidence of surgical complications between endoscopic thyroidectomy and COT.ConclusionEndoscopic thyroid surgery is a safe and effective choice for thyroid cancer patients. Different approaches have their advantages, allowing personalized selection based on the patient’s needs. ABBA and UABA have shorter operative times, while UABA and ACA excel at controlling bleeding and shortening hospital stays. OA shows promise for lymph node assessment. These findings contribute to the growing evidence supporting endoscopic methods, expanding treatment options for thyroid cancer patients.

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Remote Access Thyroid Surgery: A Review of Literature

Cited by 10 publications

References 55 publications

Surgical Steps of Gasless Transaxillary Endoscopic Thyroidectomy: From A to Z

Surgical Steps of Gasless Transaxillary Endoscopic Thyroidectomy: From A to Z

Advances in the assessment of cosmetic outcomes, sensory alteration in surgical areas, and health-related quality of life of endoscopic thyroidectomy

Surgical outcomes of endoscopic thyroidectomy approaches for thyroid cancer: a systematic review and network meta-analysis

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