Abstract：
BACKGROUND: This paper reports on the first experience after implementation of a transoral endoscopic thyroidectomy via vestibular approach (TOETVA) as an alternative to (partial) thyroidectomy or isthmusectomy in a single center. Feasibility, implementation and specific complications are addressed.
METHODS: All patients who underwent a TOETVA procedure in our center between November 2019 and March 2023 were included. The surgical technique was performed as described by Anuwong et al. All procedures were performed by two dedicated head- and neck surgeons.
RESULTS: A total of 20 patients were included. All patients underwent TOETVA surgery as planned and no conversions were needed. Observed complications were post-operative wound infections (POWI) (2/20; 10%), clinically significant seroma (1/20, 5%) and unilateral hemiparesis of the larynx (3/20; 15%). Permanent mental nerve damage was seen in 3/20 patients (15%), and 4 other patients (20%) experienced transient neuropraxia.
CONCLUSIONS: TOETVA is a feasible alternative to (partial) thyroidectomy or isthmusectomy in selected patients. Special care should be taken when placing the trocars in the oral vestibulum to prevent mental nerve damage. Experience and training are essential for implementing the TOETVA procedure.
BACKGROUND: This study was registered to ClinicalTrials.gov.
BACKGROUND: NCT05396703.
METHODS: All patients who underwent a TOETVA procedure in our center between November 2019 and March 2023 were included. The surgical technique was performed as described by Anuwong et al. All procedures were performed by two dedicated head- and neck surgeons.
RESULTS: A total of 20 patients were included. All patients underwent TOETVA surgery as planned and no conversions were needed. Observed complications were post-operative wound infections (POWI) (2/20; 10%), clinically significant seroma (1/20, 5%) and unilateral hemiparesis of the larynx (3/20; 15%). Permanent mental nerve damage was seen in 3/20 patients (15%), and 4 other patients (20%) experienced transient neuropraxia.
CONCLUSIONS: TOETVA is a feasible alternative to (partial) thyroidectomy or isthmusectomy in selected patients. Special care should be taken when placing the trocars in the oral vestibulum to prevent mental nerve damage. Experience and training are essential for implementing the TOETVA procedure.
BACKGROUND: This study was registered to ClinicalTrials.gov.
BACKGROUND: NCT05396703.
摘要：
背景：本文报道了在单中心通过前庭入路（TOETVA）实施经口内镜甲状腺切除术作为（部分）甲状腺切除术或峡部切除术的替代方法后的首次经验。可行性,解决了实施和具体的并发症。
方法：纳入2019年11月至2023年3月在我们中心接受TOETVA手术的所有患者。手术技术如Anuwong等人所述进行。所有手术均由两名专门的头颈外科医生进行。
结果：共纳入20例患者。所有患者均按计划进行了TOETVA手术，无需转换。观察到的并发症是术后伤口感染（POWI）（2/20;10％），临床显着血清肿（1/20，5％）和喉单侧偏瘫（3/20;15％）。永久性精神神经损伤见于3/20患者（15%），另外4名患者（20％）经历了短暂性神经衰弱。
结论：在特定患者中，TOETVA是（部分）甲状腺切除术或峡部切除术的可行替代方案。将套管针放置在口腔前庭时应特别小心，以防止精神神经损伤。经验和培训对于实施TOETVA程序至关重要。
背景：这项研究已在ClinicalTrials.gov注册。
背景：NCT05396703。
方法：纳入2019年11月至2023年3月在我们中心接受TOETVA手术的所有患者。手术技术如Anuwong等人所述进行。所有手术均由两名专门的头颈外科医生进行。
结果：共纳入20例患者。所有患者均按计划进行了TOETVA手术，无需转换。观察到的并发症是术后伤口感染（POWI）（2/20;10％），临床显着血清肿（1/20，5％）和喉单侧偏瘫（3/20;15％）。永久性精神神经损伤见于3/20患者（15%），另外4名患者（20％）经历了短暂性神经衰弱。
结论：在特定患者中，TOETVA是（部分）甲状腺切除术或峡部切除术的可行替代方案。将套管针放置在口腔前庭时应特别小心，以防止精神神经损伤。经验和培训对于实施TOETVA程序至关重要。
背景：这项研究已在ClinicalTrials.gov注册。
背景：NCT05396703。
