Moreno Llorente Pablo, Pascua-Solé Mireia, García Barrasa Arantxa, Francos Martínez José Manuel, Muñoz de Nova José Luis, Fernández Ranvier Gustavo, Vidal Fortuny Jordi
Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain.
Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, Universidad de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain.
Cir Esp (Engl Ed). 2023 Jan;101(1):35-42. doi: 10.1016/j.cireng.2022.07.010. Epub 2022 Jul 25.
Trans Oral Endoscopic Thyroidectomy through Vestibular Approach (TOETVA) allows access to the thyroid with the best cosmetic results as there are no visible scars.
Here we present a prospective observational study of 53 patients which underwent TOETVA from July 2017 to June 2021.
Fifty-two cases (98.1%) cases were women (median age 44 years old). Thyroid nodule was the main surgical indication accounting 73.6% of cases. We performed 42 lobectomies and 11 total thyroidectomies; 4 left Central Neck Dissection (CND) were also associated. The median surgical time for port placement was 14 min and for lobectomy, total thyroidectomy and left CND were 80, 140 and 30 min, respectively. The median of hospital stay was 2 days. Dysphonia was present in 4 patients; however, laryngoscopy only confirmed laryngeal nerve impairment in 2 cases, one of them classified as permanent (1.6%). In those patients that underwent total thyroidectomy, the rate of transient hypoparathyroidism was 18.2% whereas permanent was 0%. Regarding complications associated to the new approach, transient chin numbness appeared in all patients with a variable degree of intensity.
Transoral surgery is a recent approach in our Unit. Our results, based on the first 53 patients, show that it is a safe and effective approach when performed in appropriately selected patients offering the best cosmetic result. Besides, new complications associated to the approach has been shown to be transient.
经口前庭入路内镜甲状腺切除术（TOETVA）可在不留下可见瘢痕的情况下暴露甲状腺，从而获得最佳的美容效果。
我们在此呈现一项对2017年7月至2021年6月期间接受TOETVA手术的53例患者进行的前瞻性观察研究。
52例（98.1%）为女性（中位年龄44岁）。甲状腺结节是主要手术指征，占病例的73.6%。我们实施了42例甲状腺叶切除术和11例全甲状腺切除术；还进行了4例左侧中央区颈部淋巴结清扫术（CND）。置入端口的中位手术时间为14分钟，甲状腺叶切除术、全甲状腺切除术和左侧CND的中位手术时间分别为80分钟、140分钟和30分钟。中位住院时间为2天。4例患者出现声音嘶哑；然而，喉镜检查仅证实2例喉返神经损伤，其中1例为永久性损伤（1.6%）。在接受全甲状腺切除术的患者中，暂时性甲状旁腺功能减退的发生率为18.2%，永久性甲状旁腺功能减退的发生率为0%。关于与新手术方法相关的并发症，所有患者均出现不同程度的暂时性颏部麻木。
经口手术是我们科室近期开展的一种手术方法。基于首批53例患者的结果表明，在经过适当选择的患者中实施该手术是一种安全有效的方法，可获得最佳的美容效果。此外，与该手术方法相关的新并发症已被证明是暂时性的。
