Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single Institution

ABSTRACT Objective: To present the perioperative data of patients with solitary or multinodular goiter and/ or papillary thyroid carcinoma who underwent Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) in a single tertiary medical center. Methods: Design: Case series Set...

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Main Authors: Lawrence Maliwat, Rowald Rey Malahito, Erasmo Gonzalo Llanes
Format: Article
Language:English
Published: Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. 2020-05-01
Series:Philippine Journal of Otolaryngology Head and Neck Surgery
Subjects:
Online Access:https://pjohns.pso-hns.org/index.php/pjohns/article/view/1279
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spelling doaj-869f612a9c7041429ada9ac77729d9e52020-11-25T03:45:59ZengPhilippine Society of Otolaryngology-Head and Neck Surgery, Inc.Philippine Journal of Otolaryngology Head and Neck Surgery1908-48892094-15012020-05-0135110.32412/pjohns.v35i1.1279Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single InstitutionLawrence Maliwat0Rowald Rey Malahito1Erasmo Gonzalo Llanes2Quirino Memorial Medical Center; Bataan General Hospital and Medical CenterQuirino Memorial Medical Center; Amang Rodriguez Memorial Medical CenterQuirino Memorial Medical Center ABSTRACT Objective: To present the perioperative data of patients with solitary or multinodular goiter and/ or papillary thyroid carcinoma who underwent Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) in a single tertiary medical center. Methods: Design: Case series Setting: Tertiary Government Hospital Participants: Records of 10 patients who underwent TOETVA from June 2018 to July 2019 (9 thyroid lobectomies, 1 total thyroidectomy) were reviewed. Outcomes and measures included conversion to open surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue pain scores (VAS), and postoperative complications. Results: None of the 10 patients were converted to an open procedure. The average preoperative thyroid size was 4.73 cm in widest diameter using thyroid ultrasound (±1.88 cm, range 3.6 to 6.5 cm). Mean operative time for thyroid lobectomy and total thyroidectomy was 4 hours and 29 minutes and 4 hours and 15 minutes, respectively. Mean intraoperative blood loss was 140 ml (±47.96 ml, range 80 to 200 ml) for thyroid lobectomy and 100 ml for total thyroidectomy. The average intraoperative size of the thyroid gland measured in widest diameter (larger lobe for total thyroidectomy) was 4.48 cm (±0.919 cm, range 3 to 5.5 cm). Median postoperative hospital stay was 2 days (±1.55 days, range 2 to 12 days). Mean VAS pain scores for postoperative days 1, 2, 3, and 7 were 5, 3, 2, and 0, respectively. Transient recurrent laryngeal nerve injury (of 3 months duration) occurred in 1 patient. Two cases had surgical site infection, 2 had wound dehiscence, 1 had seroma and 1 had skin burn as a complication. None had hypocalcemia or mental nerve injury in the series. Conclusions: TOETVA was replicated in the local setting and a presentation of the perioperative data of all the patients who underwent this novel technique, the indications, as well as surgical and patient outcomes, were described. Keywords: TOETVA; thyroidectomy; transoral; endoscopic; minimally invasive https://pjohns.pso-hns.org/index.php/pjohns/article/view/1279TOETVAthyroidectomytransoralendoscopicminimally invasive
collection DOAJ
language English
format Article
sources DOAJ
author Lawrence Maliwat
Rowald Rey Malahito
Erasmo Gonzalo Llanes
spellingShingle Lawrence Maliwat
Rowald Rey Malahito
Erasmo Gonzalo Llanes
Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single Institution
Philippine Journal of Otolaryngology Head and Neck Surgery
TOETVA
thyroidectomy
transoral
endoscopic
minimally invasive
author_facet Lawrence Maliwat
Rowald Rey Malahito
Erasmo Gonzalo Llanes
author_sort Lawrence Maliwat
title Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single Institution
title_short Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single Institution
title_full Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single Institution
title_fullStr Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single Institution
title_full_unstemmed Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for Thyroid Nodules: A Series of the First 10 Patients in a Single Institution
title_sort transoral endoscopic thyroidectomy vestibular approach (toetva) for thyroid nodules: a series of the first 10 patients in a single institution
publisher Philippine Society of Otolaryngology-Head and Neck Surgery, Inc.
series Philippine Journal of Otolaryngology Head and Neck Surgery
issn 1908-4889
2094-1501
publishDate 2020-05-01
description ABSTRACT Objective: To present the perioperative data of patients with solitary or multinodular goiter and/ or papillary thyroid carcinoma who underwent Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) in a single tertiary medical center. Methods: Design: Case series Setting: Tertiary Government Hospital Participants: Records of 10 patients who underwent TOETVA from June 2018 to July 2019 (9 thyroid lobectomies, 1 total thyroidectomy) were reviewed. Outcomes and measures included conversion to open surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue pain scores (VAS), and postoperative complications. Results: None of the 10 patients were converted to an open procedure. The average preoperative thyroid size was 4.73 cm in widest diameter using thyroid ultrasound (±1.88 cm, range 3.6 to 6.5 cm). Mean operative time for thyroid lobectomy and total thyroidectomy was 4 hours and 29 minutes and 4 hours and 15 minutes, respectively. Mean intraoperative blood loss was 140 ml (±47.96 ml, range 80 to 200 ml) for thyroid lobectomy and 100 ml for total thyroidectomy. The average intraoperative size of the thyroid gland measured in widest diameter (larger lobe for total thyroidectomy) was 4.48 cm (±0.919 cm, range 3 to 5.5 cm). Median postoperative hospital stay was 2 days (±1.55 days, range 2 to 12 days). Mean VAS pain scores for postoperative days 1, 2, 3, and 7 were 5, 3, 2, and 0, respectively. Transient recurrent laryngeal nerve injury (of 3 months duration) occurred in 1 patient. Two cases had surgical site infection, 2 had wound dehiscence, 1 had seroma and 1 had skin burn as a complication. None had hypocalcemia or mental nerve injury in the series. Conclusions: TOETVA was replicated in the local setting and a presentation of the perioperative data of all the patients who underwent this novel technique, the indications, as well as surgical and patient outcomes, were described. Keywords: TOETVA; thyroidectomy; transoral; endoscopic; minimally invasive
topic TOETVA
thyroidectomy
transoral
endoscopic
minimally invasive
url https://pjohns.pso-hns.org/index.php/pjohns/article/view/1279
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AT erasmogonzalollanes transoralendoscopicthyroidectomyvestibularapproachtoetvaforthyroidnodulesaseriesofthefirst10patientsinasingleinstitution
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