Trans oral endoscopic thyroidectomy (TOETVA): First French experience in 90 patients

Deroide, G.; Honigman, Isabelle; Berthe, Adama; Branger, Frédéric; Cussac‐Pillegand, C.; Richa, Hubert; Anuwong, Angkoon

doi:10.1016/j.jviscsurg.2021.02.001

Cited by 19 publications

(4 citation statements)

References 39 publications

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“…However, more time is required to create the working space for TOETVA than for COT. Deroide et al ( 19 ) further observed that the workspace was greater in patients with wide necks than in those with slender necks. Smaller workspaces can make the operation more difficult under the endoscope, which can lead to a longer operation time.…”

Section: Discussionmentioning

confidence: 96%

Comparison Between Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) and Conventional Open Thyroidectomy for Patients Undergoing Total Thyroidectomy and Central Neck Dissection: A Propensity Score-Matching Analysis

et al. 2022

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BackgroundUse of the novel transoral endoscopic thyroidectomy vestibular approach (TOETVA) is increasing worldwide. Although several studies have compared safety and efficacy of TOETVA and other approaches, most focused on comparisons in the context of unilateral thyroidectomy. Therefore, the present study aimed to compare the safety and surgical completeness of TOETVA with conventional open thyroidectomy (COT) in patients with papillary thyroid carcinoma (PTC) undergoing total thyroidectomy and central neck dissection.MethodsThe medical records of patients who underwent TOETVA or COT by a single surgeon between June 2017 and October 2021 were retrospectively reviewed. All patients were diagnosed with PTC and underwent total thyroidectomy with central neck dissection. Propensity score-matching (PSM) was used to reduce potential selection bias and to adjust for differences in baseline clinicopathological characteristics.ResultsAfter PSM, 84 (TOETVA: 28; COT: 56) patients remained in the study population. There were no significant differences in sex, mean age, combined thyroiditis, tumor size, capsule invasion, tumor multifocality in the same lobe, or tumor location between the groups. Operative time was longer (190.54 ± 28.26 vs. 123.93 ± 29.78 min, P<0.001), while postoperative drainage volume (161.07 ± 225.30 vs. 71.16 ± 28.56 ml, P=0.045) was greater, in the TOETVA group than in the COT group. The groups exhibited no significant differences in the mean number of central lymph nodes retrieved (9.39 ± 4.01 vs. 10.71 ± 5.17, P=0.202), mean number of metastatic central lymph nodes (1.36 ± 1.93 vs. 1.77 ± 2.31, P=0.421), postoperative mean thyroglobulin levels (0.08 ± 0.24 vs. 0.10 ± 0.27, P=0.686), rate of transient hypoparathyroidism (TOETVA: 67.9% vs. COT: 66.1%, P=0.870), rate of transient vocal cord palsy (TOETVA: 0% vs. COT: 1.8%, P=1.000), or other complications (TOETVA: 3.6% vs. COT: 0%, P=0.333).ConclusionsTOETVA is a safe approach in select patients with PTC and exhibits similar efficacy to COT in terms of surgical completeness.

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Section: Discussionmentioning

confidence: 96%

Comparison Between Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) and Conventional Open Thyroidectomy for Patients Undergoing Total Thyroidectomy and Central Neck Dissection: A Propensity Score-Matching Analysis

et al. 2022

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“…[18,19] ET offers a variety of incision options, with diverse surgical approaches including the neck, subclavian, sternal incision, chest breast, axillary breast, total areola, floor of mouth, oral vestibular, and retroauricular hairline approaches. [20][21][22] The oral approach, for rendering scars virtually imperceptible, presents operational challenges and heightened risk of internal infection in the wound. Therefore, its application necessitates cautious use unless sufficient expertise is available.…”

Section: Discussionmentioning

confidence: 99%

A study on the safety and efficacy of endoscopic thyroidectomy via axillary approach for the treatment of thyroid cancer

Wang,

Zhang,

Wang

et al. 2024

Medicine

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This study aims to evaluate the safety and efficacy of endoscopic thyroid cancer treatment using an axillary approach. Participants were allocated into 2 groups: one undergoing transaxillary endoscopic surgery and the other, traditional open surgery. We compared intraoperative and postoperative conditions, focusing on parameters such as intraoperative blood loss, duration of surgery, length of postoperative hospitalization, volume of postoperative drainage, number of lymph nodes cleared in the central region, neck pain scores, neck injury indices, cosmetic satisfaction, postoperative complications, and total hospitalization duration. Patients in the endoscopic treatment (ET) group experienced longer surgical times, less intraoperative bleeding, and increased postoperative drainage. These indicators showed significant differences between the groups (P < .05). For the group undergoing endoscopic surgery via the axillary approach, there was a lower neck pain score on the third postoperative day and higher cosmetic satisfaction at 3 months. However, there were no significant differences between the groups in terms of the number of lymph nodes cleared in the central area, and the incidence of complications such as difficulty breathing, difficulty swallowing, hoarseness, and subcutaneous hematoma (P > .05). The axillary approach endoscopic surgery group also showed significantly prolonged surgery times and postoperative hospital stays, with a significant increase in postoperative drainage fluid (P < .05). Concurrently, this technique involved smaller surgical incisions and effectively concealed scars in the armpit, leading to better outcomes in terms of intraoperative bleeding, neck pain scores, and postoperative cosmetic satisfaction. Non-inflatable ET via the axillary approach for treating thyroid cancer demonstrates promising efficacy and safety. It offers additional benefits of minimal pain and enhanced cosmetic outcomes, making it a viable option for clinical adoption and application.

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“…Certainly, TOETVA provides better cosmetic results according to the invisible oral vestibule incisions. However, from review literature [10][11][12][13][14][15][16][17][18][19], there is no prospective study to demonstrate the effectiveness and safety of this procedure. Therefore, long tern follow-up well designed randomized control trials are required.…”

Section: Discussionmentioning

confidence: 99%

Surgical Results of Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) Compared to Open Thyroidectomy in Patient with Benign Thyroid Nodule

Koichusakul¹,

Ketwong²

2021

ASS

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Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an innovative technique to perform thyroidectomy which provides excellent cosmetic and surgical outcomes. Methods: Between June 2018 to January 2020 all patients pathological diagnosis with benign thyroid nodule in Chiangrai Prachanukroh Hospital were reviewed retrospectively. TOETVA and Open thyroidectomy were performed in 55 cases per each group, respectively. Patient baseline characteristics and surgical results, including postoperative pain, estimate blood loss, operative time, length of hospital stay and postoperative complications, were investigated and compared. Results: TOETVA and open thyroidectomy was performed on 110 consecutive patients. The baseline characteristics were similar in both groups. The mean postoperative visual analog scale for pain score in the first three days was comparable for both groups (4.43 [2.01] vs 3.73 [2.5], P=0.126). Mean estimate blood loss was not statistically different for both groups (20 [76.19] vs 30 [44.28] ml, P=0.302). But the median operative time was longer for the TOETVA group compared to the open thyroidectomy group (120 [61.55] vs 60 [33.70] mins, P=0.00003). Mean length of stay was comparable for both groups (3.7 [0.98] vs 3.43 [1.05] days, P=0.072). For the postoperative complication, 3 patients (5.45%) in TOETVA and 6 patients (10.91%) in open thyroidectomy group has recurrent laryngeal nerve injury. One patient (1.82%) had hypocalcemia in both groups. In TOETVA group, one patient (1.82%) had wound infection and one patient (1.82%) had transient mental nerve injury. Conclusion: TOETVA is an effective and safe surgical approach for benign thyroid nodule with excellent cosmetic outcome. This technique is a reasonable optional treatment for patients who demanded a scarless wound. The surgical outcomes and complication rates were similar but TOETVA is associated with longer operative time.

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Trans oral endoscopic thyroidectomy (TOETVA): First French experience in 90 patients

Cited by 19 publications

References 39 publications

Comparison Between Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) and Conventional Open Thyroidectomy for Patients Undergoing Total Thyroidectomy and Central Neck Dissection: A Propensity Score-Matching Analysis

Comparison Between Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) and Conventional Open Thyroidectomy for Patients Undergoing Total Thyroidectomy and Central Neck Dissection: A Propensity Score-Matching Analysis

A study on the safety and efficacy of endoscopic thyroidectomy via axillary approach for the treatment of thyroid cancer

Surgical Results of Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) Compared to Open Thyroidectomy in Patient with Benign Thyroid Nodule

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