Transoral Endoscopic Thyroidectomy Vestibular Approach for Selected Thyroid Nodules: A Case Series

  • OBJECTIVES
    To present the general and perioperative data of patients who underwent TOETVA for selected thyroid nodules in a single tertiary medical center.

    METHODS
    Case series involving chart review of patients who underwent TOETVA in Quirino Memorial Medical Center from June to October 2018. A total of 7 patients underwent the procedure, in which 6 cases had a thyroid lobectomy (85.71%) and 1 case had a total thyroidectomy (14.29%). Outcomes and measures include conversion to open, operative time, intra-operative blood loss, size of the thyroid gland, post-operative hospital stay, VAS pain scores, and post-operative complications.

    RESULTS
    None of the 7 patients were converted to an open procedure. The average pre-operative thyroid size was 5.05 cm. Mean operative time for lobectomy and total thyroidectomy was 296 and 255 min, respectively. Mean intra-operative blood loss was 143 mL for lobectomy and 100 mL for total thyroidectomy. The average actual size of the thyroid gland was 4.69 cm. Mean post-operative hospital stay was 3 days. Mean VAS pain score for post-operative days 1, 2, 3, and 7 were 4, 3, 2, and 0, respectively. Among the cases, 2 had both surgical site infection and wound dehiscence, 1 had seroma, and 1 had skin burn. None had recurrent laryngeal nerve injury, hypocalcemia, or mental nerve injury in the series.

    CONCLUSIONS
    TOETVA is a novel technique that is a viable alternative to patients who are motivated by its advantages, however, unconventional complications must be considered when discussing this procedure to interested patients.

 

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