经口甲状腺切除术（TOETVA）：并发症、手术时间和学习曲线。
Transoral thyroidectomy (TOETVA): Complications, surgical time and learning curve.
机构信息
Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, Sao Paulo, Brazil.
出版信息
Oral Oncol. 2020 Nov;110:104871. doi: 10.1016/j.oraloncology.2020.104871. Epub 2020 Jun 30.
BACKGROUND
Since 2018, transoral endoscopic thyroidectomy vestibular approach (TOETVA) has emerged as a true scarless thyroid surgery. In this study, we explore early outcomes and learning curve of this new approach.
METHODS
A retrospective cohort including conventional thyroidectomies and TOETVAs performed in a cancer center was designed. Learning curve and early surgical outcomes of TOETVA were assessed and compared to conventional thyroidectomy.
RESULTS
A total of 56 TOETVAs and 745 conventional thyroid procedures were included. In the TOETVA group, we had a 14.4% total complication rate with no permanent vocal cord paresis or hypocalcemia. The mean surgical time dropped from 167 to 117 min (p = 0.0001) after the 15 first cases. Comparing to conventional procedures, we didn't find any significant difference in complications rate. Operative time was longer in the TOETVA group.
CONCLUSIONS
In this study, TOETVA was safe and feasible, with a learning curve of 15 cases.
背景
自 2018 年以来，经口内镜甲状腺手术（TOETVA）已成为一种真正的无疤痕甲状腺手术。本研究旨在探讨该新术式的早期结果和学习曲线。
方法
设计了一项回顾性队列研究，包括在癌症中心进行的常规甲状腺切除术和 TOETVA。评估了 TOETVA 的学习曲线和早期手术结果，并与常规甲状腺切除术进行了比较。
结果
共纳入 56 例 TOETVA 和 745 例常规甲状腺手术。TOETVA 组总并发症发生率为 14.4%，无永久性声带麻痹或低钙血症。在完成前 15 例手术后，手术时间从 167 分钟降至 117 分钟（p=0.0001）。与常规手术相比，TOETVA 组的并发症发生率无显著差异。TOETVA 组的手术时间较长。
结论
本研究表明，TOETVA 安全可行，学习曲线为 15 例。
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