Abstract | BACKGROUND: METHODS: We retrospectively reviewed all patients who had papillary thyroid carcinoma that was between >1 cm and ≤3.5 cm in diameter and who had undergone the transoral endoscopic thyroidectomy vestibular approach (n = 96) or an open thyroidectomy (n = 425) from January 2017 to June 2020. We then performed 1:1 propensity score matching, yielding 78 matched pairs. Afterward, surgical outcomes and follow-up data were compared between the 2 matched groups. RESULTS: Compared with the matched open thyroidectomy group, the papillary thyroid carcinoma group had a significantly longer operative time (P < .001), more blood loss (P < .05), higher postoperative white blood cell count (P < .05), higher C-reactive protein (P < .001), more total drainage volume (P < .001), increased surgical cost (P < .05), better cosmetic satisfaction (P <.001), lower scar self-consciousness (P < .001), and better quality of life (P < .001). We observed no significant differences in the incidence of other outcomes, including the number of retrieved lymph nodes and metastatic central lymph nodes, the rate of intraoperative recurrent laryngeal nerve signal weakened and parathyroid autotransplantation, visual analog scale scores for pain, drainage duration, postoperative hospital stay, rate of complications, and oncologic completeness. We observed no conversion to open thyroidectomy and no intraoperative capsular disruption in the transoral endoscopic thyroidectomy vestibular approach group. There was 1 case of persistent nodal disease in the transoral endoscopic thyroidectomy vestibular approach group. No recurrence was observed in the 2 groups during the follow-up period. CONCLUSION: The transoral endoscopic thyroidectomy vestibular approach is feasible in selected patients with papillary thyroid carcinoma, not only because it is cosmetically advantageous but also because it is surgical and oncologically safe and may be an optional surgical method for treating papillary thyroid carcinomas having a diameter between >1 cm and ≤3.5 cm.
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Authors | Zhaodi Liu, Yujun Li, Yong Wang, Cheng Xiang, Xing Yu, Maolin Zhang, Ping Wang |
Journal | Surgery
(Surgery)
Vol. 170
Issue 6
Pg. 1680-1686
(12 2021)
ISSN: 1532-7361 [Electronic] United States |
PMID | 34284897
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2021 Elsevier Inc. All rights reserved. |
Topics |
- Adult
- Esthetics
- Feasibility Studies
- Female
- Follow-Up Studies
- Humans
- Length of Stay
- Male
- Middle Aged
- Natural Orifice Endoscopic Surgery
(adverse effects, methods, statistics & numerical data)
- Operative Time
- Patient Satisfaction
(statistics & numerical data)
- Postoperative Complications
(epidemiology, etiology)
- Propensity Score
- Retrospective Studies
- Thyroid Cancer, Papillary
(surgery)
- Thyroid Neoplasms
(surgery)
- Thyroidectomy
(adverse effects, methods, statistics & numerical data)
- Treatment Outcome
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