Haiqing Sun1, Haitao Zheng1, Xiaojie Wang1, Qingdong Zeng2, Ping Wang3, Yong Wang4. 1. Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, 264000, Shangdong, China. 2. Department of Thyroid Surgery, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China. 3. Department of Thyroid Surgery, The Second Affiliated Hospital of Zhejiang University, School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. 4. Department of Thyroid Surgery, The Second Affiliated Hospital of Zhejiang University, School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China. surgwy@zju.edu.cn.
Abstract
BACKGROUND: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) and total endoscopic thyroidectomy via areola approach (ETA) are commonly used endoscopic thyroidectomy approaches. This study compares the effectiveness of these approaches with conventional open thyroidectomy (COT) in terms of safety, associated trauma, and feasibility of central neck dissection in the treatment of papillary thyroid carcinoma (PTC). METHODS: This retrospective study included patients who underwent TOETVA (n = 100), ETA (n = 119), and COT (n = 289). All patients had a pathological diagnosis of PTC and underwent unilateral lobectomy and central neck dissection. We analyzed operative time, postoperative drainage volume, postoperative C-reactive protein (CRP), preoperative and postoperative white blood cell (WBC) count and parathyroid hormone (PTH) levels, parathyroid damage, hoarseness, total number of central lymph nodes, and number of metastatic central lymph nodes. RESULTS: The clinical characteristics across the three groups were similar except for patient sex and age. There was a higher proportion of young women in the TOETVA and ETA groups than in the COT group. There were significant differences between the three groups regarding operative time (P = 0.000), postoperative drainage volume (P = 0.000), postoperative CRP (P = 0.000), ∆WBC (P = 0.000), and length of postoperative hospital stay (P = 0.021); in the TOETVA and ETA groups, operative time (P = 0.445), postoperative drainage volume (P = 0.677), and length of postoperative hospital stay (P = 0.145) were not significantly different. The percentage of cases with parathyroid gland damage (P = 0.459) and hoarseness (P > 0.05) was similar in all groups. All three procedures were efficient in performing a central lymph node dissection. CONCLUSIONS: Although considered more traumatic, TOETVA and ETA are both safe treatment options for PTC. They can both achieve similar therapeutic effects of central neck dissection in the treatment of PTC when compared with open surgery.
BACKGROUND: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) and total endoscopic thyroidectomy via areola approach (ETA) are commonly used endoscopic thyroidectomy approaches. This study compares the effectiveness of these approaches with conventional open thyroidectomy (COT) in terms of safety, associated trauma, and feasibility of central neck dissection in the treatment of papillary thyroid carcinoma (PTC). METHODS: This retrospective study included patients who underwent TOETVA (n = 100), ETA (n = 119), and COT (n = 289). All patients had a pathological diagnosis of PTC and underwent unilateral lobectomy and central neck dissection. We analyzed operative time, postoperative drainage volume, postoperative C-reactive protein (CRP), preoperative and postoperative white blood cell (WBC) count and parathyroid hormone (PTH) levels, parathyroid damage, hoarseness, total number of central lymph nodes, and number of metastatic central lymph nodes. RESULTS: The clinical characteristics across the three groups were similar except for patient sex and age. There was a higher proportion of young women in the TOETVA and ETA groups than in the COT group. There were significant differences between the three groups regarding operative time (P = 0.000), postoperative drainage volume (P = 0.000), postoperative CRP (P = 0.000), ∆WBC (P = 0.000), and length of postoperative hospital stay (P = 0.021); in the TOETVA and ETA groups, operative time (P = 0.445), postoperative drainage volume (P = 0.677), and length of postoperative hospital stay (P = 0.145) were not significantly different. The percentage of cases with parathyroid gland damage (P = 0.459) and hoarseness (P > 0.05) was similar in all groups. All three procedures were efficient in performing a central lymph node dissection. CONCLUSIONS: Although considered more traumatic, TOETVA and ETA are both safe treatment options for PTC. They can both achieve similar therapeutic effects of central neck dissection in the treatment of PTC when compared with open surgery.
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568
Authors: David Saavedra-Perez; Marti Manyalich; Paula Dominguez; Jaime Vilaça; Julio Jordan; Miguel A Lopez-Boado; Ramon Rull; Oscar Vidal Journal: BJS Open Date: 2022-07-07