J Endocr Surg.  2021 Mar;21(1):13-19. 10.16956/jes.2021.21.1.13.

Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Treatment for Benign Thyroid Diseases

• Fernández-Ranvier GG
• Guevara D
• Alawwa G
• Meknat A
• Lieberman B
• B Inabnet W

• KMID: 2525948
• DOI: http://doi.org/10.16956/jes.2021.21.1.13

Abstract

Purpose
Thyroidectomy is often required in the management of benign thyroid disorders. Conventional open thyroidectomy remains the standard of care for various benign and malignant thyroid disorders. We aim to present our experience in performing a transoral endoscopic thyroidectomy vestibular approach (TOETVA) for benign disease of the thyroid gland that is safe, and feasible when compared with open thyroidectomy.
Methods
Sixty-six patients who underwent an open thyroidectomy or TOETVA between 2014 and 2019 for a benign thyroid condition were identified and retrospectively studied. Outcomes between the 2 groups, including postoperative complications, operative time, estimated blood loss (EBL), and length of stay, were compared. Patients were followed from 2 weeks up to 2 years postoperatively.
Results
Sixty-six patients whose age ranges between 22 and 82 were stratified into an open thyroidectomy group and a TOETVA group with 33 patients in each group. In the TOETVA group, twenty-four (72.2%) patients underwent a total thyroidectomy while the rest underwent a lobectomy. One case of TOETVA was converted to open. There were no significant differences in the EBL, recurrent laryngeal nerve injury, hematoma formation, or hypocalcemia postoperatively between the 2 groups (P>0.05).
Conclusion
We conclude that when thyroidectomy, either total or partial, is pursued for the management of benign thyroid disorders, TOETVA in patients with favorable features is a viable alternative to open thyroidectomy with regards to postoperative outcomes and provides superior cosmetic results leaving the patient with no cutaneous scars.

Keyword

Natural orifice transluminal endoscopic surgery; Thyroidectomy; Thyroid disease