Chai Young Jun, Chae Sumin, Oh Moon Young, Kwon Hyungju, Park Won Seo
Department of Surgery, Seoul National University Boramae Medical Center, Seoul 07061, Korea.
Department of Surgery, Kyung Hee University College of Medicine, Kyung Hee University Medical Center 23, Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea.
J Clin Med. 2021 Feb 19;10(4):863. doi: 10.3390/jcm10040863.
The transoral endoscopic thyroidectomy vestibular approach (TOETVA) has excellent cosmetic effects and its popularity is increasing worldwide. We present our experience with TOETVA and its short-term outcomes. This study included 110 consecutive patients who underwent TOETVA at a single institution between July 2016 and June 2020. We analyzed clinicopathologic data, short-term postoperative outcomes, and learning curve using cumulative summation (CUSUM) analysis. Of the 110 patients who underwent TOETVA, 101 had malignant disease and 100 (90.9%) underwent lobectomy. The mean age was 39.7 ± 9.7 years, and the mean tumor size was 1.0 ± 0.7 cm (range, 0.3-3.6 cm). Operation time was 168.0 ± 63.4 min for total thyroidectomy, 111.0 ± 27.7 min for lobectomy, and 73.7 ± 18.1 min for isthmusectomy. Five patients (4.5%) experienced transient vocal cord palsy (VCP) and one (0.9%) had permanent VCP. The swallowing impairment index-6 score was 2.18 ± 3.21 at postoperative three months, and 0.97 ± 1.72 at postoperative six months. The learning curve for lobectomy was 58 cases in CUSUM analysis. TOETVA is a safe and feasible approach with an acceptable operation time and a low complication rate. This approach is a surgical option for patients who desire excellent cosmesis.
经口内镜甲状腺切除术前庭入路（TOETVA）具有出色的美容效果，在全球范围内的应用越来越广泛。我们介绍我们开展TOETVA的经验及其短期疗效。本研究纳入了2016年7月至2020年6月期间在单一机构连续接受TOETVA的110例患者。我们使用累积和（CUSUM）分析来分析临床病理数据、术后短期疗效和学习曲线。在接受TOETVA的110例患者中，101例患有恶性疾病，100例（90.9%）接受了叶切除术。平均年龄为39.7±9.7岁，平均肿瘤大小为1.0±0.7 cm（范围0.3 - 3.6 cm）。全甲状腺切除术的手术时间为168.0±63.4分钟，叶切除术为111.0±27.7分钟，峡部切除术为73.7±18.1分钟。5例患者（4.5%）出现短暂性声带麻痹（VCP），1例（0.9%）出现永久性VCP。术后3个月吞咽障碍指数 - 6评分为2.18±3.21，术后6个月为0.97±1.72。CUSUM分析中叶切除术的学习曲线为58例。TOETVA是一种安全可行的手术方法，手术时间可接受且并发症发生率低。对于期望获得出色美容效果的患者而言，这种手术方法是一种手术选择。
