Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (3): 58-63.doi: 10.6040/j.issn.1673-3770.1.2020.021

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The safety and feasibility of transoral endoscopic thyroidectomy vestibular approach(TOETVA)in papillary thyroid cancer

ZHENG Guibin1, ZHANG Guojun2, MA Chi1, WEI Shujian1, SUN Haiqing1, WU Guochang1, GUO Yawen1, ZHENG Haitao1, SONG Xicheng3   

  1. 1. Department of Thyroid Surgery, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong, China;
    2. Department of Thyroid and Breast Surgery, Changle County People's Hospital, Weifang 262400, Shandong, China;
    3. Department of Otorhinolaryngology & Head and Neck surgery, the Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong, China
  • Published:2020-06-29

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Abstract: Objective To explore the safety and efficiency of transoral endoscopic thyroidectomy vestibular approach(TOETVA)in papillary thyroid cancer(PTC). Methods This study retrospectively reviewed 146 patients who underwent TOETVA between June 2017 and January 2020 at the Affiliated Yantai Yuhuangding Hospital of Qingdao University. Of those, 139 patients with pathologically confirmed PTC were enrolled in this study. Analyses were performed of the workflow experience, visual pain score on the first postoperative day, length of hospital stay, number of central neck lymph nodes removed, complications, and results of follow-ups. Results A total of 135 cases required hemithyroidectomy plus isthmectomy and central neck dissection(CND)with a mean operation time of 132±34.9 min; 4 cases required total thyroidectomy and CND with a mean operation time of 168±38.5 min. The mean number of central neck lymph nodes removed was 7.1±4.6 and the metastasis rate was 47.5%(66/139). Postoperative hospital stay was 1.9±0.7 days. Regarding postoperative complications, the incidence of transient recurrent laryngeal nerve injury(RLN)and transient hypoparathyroidism was 1.4%(2/139)and 0.7%(1/139), respectively. No permanent RLN injury and hypoparathyroidism occurred. Mental nerve injury occurred in 5.0%(7/139). Transient abnormal motor function of the lower lip and marginal mandibular branches of the facial nerve was observed in nine cases and two cases, respectively. Conclusion TOETVA can be performed by standard workflow with the principle of enhanced recovery after surgery(ERAS). TOETVA is feasible in selected PTC patients for its cosmetical results and oncological safety.

Key words: 〓 Papillary thyroid cancer, Transoral vestibular approach, Enhanced recovery after surgery, Central neck dissection

CLC Number: 

  • R736
[1] Anuwong A, Kim HY, Dionigi G. Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences[J]. Gland Surg, 2017, 6(3): 277-284. doi:10.21037/gs.2017.03.16.
[2] Anuwong A, Sasanakietkul T, Jitpratoom P, et al. Transoral endoscopic thyroidectomy vestibular approach(TOETVA): indications, techniques and results[J]. Surg Endosc, 2018, 32(1): 456-465. doi:10.1007/s00464-017-5705-8.
[3] Hall CM, Snyder SK, Maldonado YM, et al. Routine central lymph node dissection with total thyroidectomy for papillary thyroid cancer potentially minimizes level VI recurrence[J]. Surgery, 2016, 160(4): 1049-1058. doi:10.1016/j.surg.2016.06.042.
[4] 周鹏, 贺青卿, 庄大勇, 等. 甲状腺乳头状癌颈部淋巴结转移规律的临床分析[J]. 山东大学耳鼻喉眼学报, 2013, 27(6): 12-15. doi: 10.6040/j.issn.1673-3770.0.2013.300. ZHOU Peng, HE Qingqing, ZHUANG Dayong, et al. Regularity of lymph node metastasis in papillary thyroid carcinoma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2013, 27(6): 12-15. doi: 10.6040/j.issn.1673-3770.0.2013.300.
[5] 中国抗癌协会头颈肿瘤专业委员会, 中国抗癌协会甲状腺癌专业委员会. 甲状腺外科ERAS中国专家共识(2018版)[J]. 中国肿瘤, 2019, 28(1): 26-38. doi: 10.11735/j.issn.1004-0242.2019.01.A004. Chinese Association of Head and Neck Oncology, Chinese Association of Thyroid Oncology. Expert Consensus on Enhanced Recovery After Surgery(ERAS)in Thyroid Surgery(2018 Edition)[J]. China cancer, 2019, 28(1): 26-38. doi: 10.11735/j.issn.1004- 0242.2019.01.A004.
[6] 王平, 吴国洋, 田文, 等. 经口腔前庭入路腔镜甲状腺手术专家共识(2018版)[J]. 中国实用外科杂志, 2018, 38(10): 1104-1107. doi:10.19538/j.cjps.issn1005-2208.2018.10.02.
[7] Wang CC, Zhai HN, Liu WJ, et al. Thyroidectomy: a novel endoscopic oral vestibular approach[J]. Surgery, 2014, 155(1): 33-38. doi:10.1016/j.surg.2013.06.010.
[8] Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases[J]. World J Surg, 2016, 40(3): 491-497. doi:10.1007/s00268-015-3320-1.
[9] 高晓倩, 姜震, 耿琛琛, 等. 术前超声评估分化型甲状腺癌颈部淋巴结转移[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 135-139. doi: doi: 10.6040/j.issn.1673-3770.0.2018.443. GAO Xiaoqian, JIANG Zhen, GENG Chenchen, et al. Preoperative ultrasonography in detecting cervical lymph node metastasis in differentiated thyroid cancer[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(1): 135-139. doi: doi: 10.6040/j.issn.1673-3770.0.2018.443.
[10] Ahn JH, Yi JW. Transoral endoscopic thyroidectomy for thyroid carcinoma: outcomes and surgical completeness in 150 single-surgeon cases[J]. Surg Endosc, 2020, 34(2): 861-867. doi:10.1007/s00464-019-06841-8.
[11] 郑桂彬, 马驰, 孙海清, 等. 经口腔前庭腔镜甲状腺手术16例[J]. 中国现代普通外科进展, 2018, 21(12): 943-946. doi: CNKI:SUN:PWJZ.0.2018-12-006. ZHENG Guibin, MA Chi, SUN Haiqing, et al. Preliminary experience with transoral endoscopic thyroidectomy vestibular approach: a report of 16 cases in a single center[J]. Chinese Journal of Current Advances in General Surgery, 2018, 21(12): 943-946. doi: CNKI:SUN:PWJZ.0.2018-12-006.
[12] Anuwong A, Ketwong K, Jitpratoom P, et al. Safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach[J]. JAMA Surg, 2018, 153(1): 21-27. doi:10.1001/jamasurg.2017.3366.
[13] Peng XW, Li Z, Li H, et al. The clinical application of mental nerve dissection in transoral endoscopic thyroidectomy via an oral vestibular approach[J]. Surg Endosc, 2020, 34(1): 153-158. doi:10.1007/s00464-019-06743-9.
[14] Kim HY, Chai YJ, Dionigi G, et al. Transoral robotic thyroidectomy: lessons learned from an initial consecutive series of 24 patients[J]. Surg Endosc, 2018, 32(2): 688-694. doi:10.1007/s00464-017-5724-5.
[15] Celik S, Makay O, Yoruk MD, et al. A surgical and anatomo-histological study on Transoral Endoscopic Thyroidectomy Vestibular Approach(TOETVA)[J]. Surg Endosc, 2020, 34(3): 1088-1102. doi:10.1007/s00464-019-06856-1.
[16] Zhang DQ, Park D, Sun H, et al. Indications, benefits and risks of transoral thyroidectomy[J]. Best Pract Res Clin Endocrinol Metab, 2019, 33(4): 101280. doi:10.1016/j.beem.2019.05.004.
[17] Wu GY, Fu JB, Lin FS, et al. Endoscopic central lymph node dissection via breast combined with oral approach for papillary thyroid carcinoma: a preliminary study[J]. World J Surg, 2017, 41(9): 2280-2282. doi:10.1007/s00268-017-4015-6.
[18] Yi JW, Yoon SG, Kim HS, et al. Transoral endoscopic surgery for papillary thyroid carcinoma: initial experiences of a single surgeon in South Korea[J]. Ann Surg Treat Res, 2018, 95(2): 73-79. doi:10.4174/astr.2018.95.2.73.
[19] 王勇, 谢秋萍, 俞星, 等. 经口腔前庭入路腔镜甲状腺手术150例临床分析[J]. 中华外科杂志, 2017, 55(8): 587-591. doi:10.3760/cma.j.issn.0529-5815.2017.08.007. Wang Yong, Xie Qiuping, Yu Xing, et al. Preliminary experience with transoral endoscopic thyroidectomy via vestibular approach: a report of 150 cases in a single center[J]. Chin J Surg, 2017, 55(8): 587-591. doi: 10.3760/cma.j.issn.0529-5815.2017.08.007.
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