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
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