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Erschienen in: Surgical Endoscopy 7/2019

28.05.2019

Transoral endoscopic thyroid surgery in a Korean population

verfasst von: Jun-Ook Park, Angkoon Anuwong, Mi Ra Kim, Dong-Il Sun, Min-Sik Kim

Erschienen in: Surgical Endoscopy | Ausgabe 7/2019

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Abstract

Background

Transoral endoscopic thyroidectomy vestibular approach is expected to be a safe alternative to open surgery for certain patients and has been used increasingly by several surgeons around the world for the past 2 years. The purpose of this paper is to review our 2-year experience and describe in detail our preoperative considerations, patient selection, operating room settings, anesthetic considerations, surgical technique, postoperative management, and outcomes.

Methods

We reviewed the medical records of 65 consecutive patients who underwent transoral endoscopic thyroidectomy between July 2016 and May 2018 in our hospital.

Results

We have performed 65 thyroid surgeries (54 thyroid lobectomies, 1 completion thyroidectomy, and 10 total thyroidectomies) in 64 patients. Postoperative pathology revealed papillary carcinoma in 55 patients (84.6%), follicular carcinoma in two (3.1%), hyalinizing trabecular tumor in one (1.5%), and other benign tumor in seven (10.8%). All surgical margins were negative. Two (3.1%) patients developed transient vocal cord palsy but recovered within 2 months. One (1.5%) patient with vocal cord palsy had not recovered by 3 months after surgery. Five (7.7%) patients who underwent total thyroidectomy developed transient hypocalcemia but recovered within 2 months.

Conclusion

Although transoral thyroid surgery is a relatively recent technique requiring further validation, it affords several advantages. Transoral thyroid surgery has not yet been universally accepted, but may be the best choice for thyroid surgery in the future.
Literatur
1.
Zurück zum Zitat Ahn HS, Kim HJ, Welch HG (2014) Korea’s thyroid-cancer “epidemic"--screening and overdiagnosis. N Engl J Med 371:1765–1767CrossRefPubMed Ahn HS, Kim HJ, Welch HG (2014) Korea’s thyroid-cancer “epidemic"--screening and overdiagnosis. N Engl J Med 371:1765–1767CrossRefPubMed
2.
Zurück zum Zitat Tan CT, Cheah WK, Delbridge L (2008) “Scarless” (in the neck) endoscopic thyroidectomy (SET): an evidence-based review of published techniques. World J Surg 32:1349–1357CrossRefPubMed Tan CT, Cheah WK, Delbridge L (2008) “Scarless” (in the neck) endoscopic thyroidectomy (SET): an evidence-based review of published techniques. World J Surg 32:1349–1357CrossRefPubMed
3.
Zurück zum Zitat Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209:e1–e7CrossRefPubMed Kang SW, Jeong JJ, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic thyroidectomy for thyroid malignancies using a gasless transaxillary approach. J Am Coll Surg 209:e1–e7CrossRefPubMed
4.
Zurück zum Zitat Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16:226–231CrossRefPubMed Yoon JH, Park CH, Chung WY (2006) Gasless endoscopic thyroidectomy via an axillary approach: experience of 30 cases. Surg Laparosc Endosc Percutan Tech 16:226–231CrossRefPubMed
5.
Zurück zum Zitat Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23:2399–2406CrossRefPubMed Kang SW, Jeong JJ, Yun JS, Sung TY, Lee SC, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 23:2399–2406CrossRefPubMed
6.
Zurück zum Zitat Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055CrossRefPubMed Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2009) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055CrossRefPubMed
7.
Zurück zum Zitat Choe JH, Kim SW, Chung KW, Park KS, Han W, Noh DY, Oh SK, Youn YK (2007) Endoscopic thyroidectomy using a new bilateral axillo-breast approach. World J Surg 31:601–606CrossRefPubMed Choe JH, Kim SW, Chung KW, Park KS, Han W, Noh DY, Oh SK, Youn YK (2007) Endoscopic thyroidectomy using a new bilateral axillo-breast approach. World J Surg 31:601–606CrossRefPubMed
8.
Zurück zum Zitat Terris DJ, Singer MC, Seybt MW (2011) Robotic facelift thyroidectomy: II. Clinical feasibility and safety. Laryngoscope 121:1636–1641CrossRefPubMed Terris DJ, Singer MC, Seybt MW (2011) Robotic facelift thyroidectomy: II. Clinical feasibility and safety. Laryngoscope 121:1636–1641CrossRefPubMed
9.
Zurück zum Zitat Terris DJ, Singer MC (2012) Qualitative and quantitative differences between 2 robotic thyroidectomy techniques. Otolaryngol Head Neck Surg 147:20–25CrossRefPubMed Terris DJ, Singer MC (2012) Qualitative and quantitative differences between 2 robotic thyroidectomy techniques. Otolaryngol Head Neck Surg 147:20–25CrossRefPubMed
10.
Zurück zum Zitat Byeon HK, Kim DH, Chang JW, Ban MJ, Park JH, Kim WS, Choi EC, Koh YW (2016) Comprehensive application of robotic retroauricular thyroidectomy: the evolution of robotic thyroidectomy. Laryngoscope 126:1952–1957CrossRefPubMed Byeon HK, Kim DH, Chang JW, Ban MJ, Park JH, Kim WS, Choi EC, Koh YW (2016) Comprehensive application of robotic retroauricular thyroidectomy: the evolution of robotic thyroidectomy. Laryngoscope 126:1952–1957CrossRefPubMed
11.
Zurück zum Zitat Moris DN, Bramis KJ, Mantonakis EI, Papalampros EL, Petrou AS, Papalampros AE (2012) Surgery via natural orifices in human beings: yesterday, today, tomorrow. Am J Surg 204:93–102CrossRefPubMed Moris DN, Bramis KJ, Mantonakis EI, Papalampros EL, Petrou AS, Papalampros AE (2012) Surgery via natural orifices in human beings: yesterday, today, tomorrow. Am J Surg 204:93–102CrossRefPubMed
12.
Zurück zum Zitat Wilhelm T, Metzig A (2011) Endoscopic minimally invasive thyroidectomy (eMIT): a prospective proof-of-concept study in humans. World J Surg 35:543–551CrossRefPubMed Wilhelm T, Metzig A (2011) Endoscopic minimally invasive thyroidectomy (eMIT): a prospective proof-of-concept study in humans. World J Surg 35:543–551CrossRefPubMed
13.
Zurück zum Zitat Wang Y, Xie QP, Yu X, Xiang C, Zhang ML, Zhao QZ, Yan HC, Wang P, Xu SM (2017) [Preliminary experience with transoral endoscopic thyroidectomy via vestibular approach: a report of 150 cases in a single center]. Zhonghua Wai Ke Za Zhi 55:587–591PubMed Wang Y, Xie QP, Yu X, Xiang C, Zhang ML, Zhao QZ, Yan HC, Wang P, Xu SM (2017) [Preliminary experience with transoral endoscopic thyroidectomy via vestibular approach: a report of 150 cases in a single center]. Zhonghua Wai Ke Za Zhi 55:587–591PubMed
14.
Zurück zum Zitat Karakas E, Steinfeldt T, Gockel A, Westermann R, Kiefer A, Bartsch DK (2010) Transoral thyroid and parathyroid surgery. Surg Endosc 24:1261–1267CrossRefPubMed Karakas E, Steinfeldt T, Gockel A, Westermann R, Kiefer A, Bartsch DK (2010) Transoral thyroid and parathyroid surgery. Surg Endosc 24:1261–1267CrossRefPubMed
15.
Zurück zum Zitat Nakajo A, Arima H, Hirata M, Mizoguchi T, Kijima Y, Mori S, Ishigami S, Ueno S, Yoshinaka H, Natsugoe S (2013) Trans-oral video-assisted neck surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc 27:1105–1110CrossRefPubMed Nakajo A, Arima H, Hirata M, Mizoguchi T, Kijima Y, Mori S, Ishigami S, Ueno S, Yoshinaka H, Natsugoe S (2013) Trans-oral video-assisted neck surgery (TOVANS). A new transoral technique of endoscopic thyroidectomy with gasless premandible approach. Surg Endosc 27:1105–1110CrossRefPubMed
16.
Zurück zum Zitat Fu J, Luo Y, Chen Q, Lin F, Hong X, Kuang P, Yan W, Wu G, Zhang Y (2018) Transoral endoscopic thyroidectomy: review of 81 cases in a single institute. J Laparoendosc Adv Surg Tech A 28:286–291CrossRefPubMed Fu J, Luo Y, Chen Q, Lin F, Hong X, Kuang P, Yan W, Wu G, Zhang Y (2018) Transoral endoscopic thyroidectomy: review of 81 cases in a single institute. J Laparoendosc Adv Surg Tech A 28:286–291CrossRefPubMed
17.
Zurück zum Zitat Anuwong A (2016) Transoral endoscopic thyroidectomy vestibular approach: A series of the first 60 human cases. World J Surg 40:491–497CrossRefPubMed Anuwong A (2016) Transoral endoscopic thyroidectomy vestibular approach: A series of the first 60 human cases. World J Surg 40:491–497CrossRefPubMed
18.
Zurück zum Zitat Chai YJ, Chung JK, Anuwong A, Dionigi G, Kim HY, Hwang KT, Heo SC, Yi KH, Lee KE (2017) Transoral endoscopic thyroidectomy for papillary thyroid microcarcinoma: initial experience of a single surgeon. Ann Surg Treat Res 93:70–75CrossRefPubMedPubMedCentral Chai YJ, Chung JK, Anuwong A, Dionigi G, Kim HY, Hwang KT, Heo SC, Yi KH, Lee KE (2017) Transoral endoscopic thyroidectomy for papillary thyroid microcarcinoma: initial experience of a single surgeon. Ann Surg Treat Res 93:70–75CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Dionigi G, Bacuzzi A, Lavazza M, Inversini D, Boni L, Rausei S, Kim HY, Anuwong A (2017) Transoral endoscopic thyroidectomy: preliminary experience in Italy. Updates Surg 69:225–234CrossRefPubMed Dionigi G, Bacuzzi A, Lavazza M, Inversini D, Boni L, Rausei S, Kim HY, Anuwong A (2017) Transoral endoscopic thyroidectomy: preliminary experience in Italy. Updates Surg 69:225–234CrossRefPubMed
20.
Zurück zum Zitat Park JO, Sun DI (2017) Transoral endoscopic thyroidectomy: our initial experience using a new endoscopic technique. Surg Endosc 31:5436–5443CrossRefPubMed Park JO, Sun DI (2017) Transoral endoscopic thyroidectomy: our initial experience using a new endoscopic technique. Surg Endosc 31:5436–5443CrossRefPubMed
21.
Zurück zum Zitat Dionigi G, Tufano RP, Russell J, Kim HY, Piantanida E, Anuwong A (2017) Transoral thyroidectomy: advantages and limitations. J Endocrinol Invest 40:1259–1263CrossRefPubMed Dionigi G, Tufano RP, Russell J, Kim HY, Piantanida E, Anuwong A (2017) Transoral thyroidectomy: advantages and limitations. J Endocrinol Invest 40:1259–1263CrossRefPubMed
22.
Zurück zum Zitat Peng XW, Li H, Li Z, Zhou X, Song DJ, Zhou B, Lv CL, Peng W (2017) Modified transoral endoscopic thyroid surgery for treatment of thyroid cancer: operative steps and video. Gland Surg 6:742–744CrossRefPubMedPubMedCentral Peng XW, Li H, Li Z, Zhou X, Song DJ, Zhou B, Lv CL, Peng W (2017) Modified transoral endoscopic thyroid surgery for treatment of thyroid cancer: operative steps and video. Gland Surg 6:742–744CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Kim HY, Chai YJ, Dionigi G, Anuwong A, Richmon JD (2018) Transoral robotic thyroidectomy: lessons learned from an initial consecutive series of 24 patients. Surg Endosc 32:688–694CrossRefPubMed Kim HY, Chai YJ, Dionigi G, Anuwong A, Richmon JD (2018) Transoral robotic thyroidectomy: lessons learned from an initial consecutive series of 24 patients. Surg Endosc 32:688–694CrossRefPubMed
24.
Zurück zum Zitat Jitpratoom P, Ketwong K, Sasanakietkul T, Anuwong A (2016) Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy. Gland Surg 5:546–552CrossRefPubMedPubMedCentral Jitpratoom P, Ketwong K, Sasanakietkul T, Anuwong A (2016) Transoral endoscopic thyroidectomy vestibular approach (TOETVA) for Graves’ disease: a comparison of surgical results with open thyroidectomy. Gland Surg 5:546–552CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Chai YJ, Kim HY, Kim HK, Jun SH, Dionigi G, Anuwong A, Richmon JD, Tufano RP (2018) Comparative analysis of 2 robotic thyroidectomy procedures: Transoral versus bilateral axillo-breast approach. Head Neck 40:886–892CrossRefPubMed Chai YJ, Kim HY, Kim HK, Jun SH, Dionigi G, Anuwong A, Richmon JD, Tufano RP (2018) Comparative analysis of 2 robotic thyroidectomy procedures: Transoral versus bilateral axillo-breast approach. Head Neck 40:886–892CrossRefPubMed
27.
Zurück zum Zitat Anuwong A, Sasanakietkul T, Jitpratoom P, Ketwong K, Kim HY, Dionigi G, Richmon JD (2018) Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques and results. Surg Endosc 32:456–465CrossRefPubMed Anuwong A, Sasanakietkul T, Jitpratoom P, Ketwong K, Kim HY, Dionigi G, Richmon JD (2018) Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques and results. Surg Endosc 32:456–465CrossRefPubMed
29.
Zurück zum Zitat Kim KN, Lee DW, Kim JY, Han KH, Tae K (2018) Carbon dioxide embolism during transoral robotic thyroidectomy: a case report. Head Neck 40:E25–E28CrossRefPubMed Kim KN, Lee DW, Kim JY, Han KH, Tae K (2018) Carbon dioxide embolism during transoral robotic thyroidectomy: a case report. Head Neck 40:E25–E28CrossRefPubMed
30.
Zurück zum Zitat Anuwong A (2017) Strategy to prevent subcutaneous emphysema and gas insufflation-related complications in transoral endoscopic thyroidectomy vestibular approach: reply. World J Surg 41:2649–2650CrossRefPubMed Anuwong A (2017) Strategy to prevent subcutaneous emphysema and gas insufflation-related complications in transoral endoscopic thyroidectomy vestibular approach: reply. World J Surg 41:2649–2650CrossRefPubMed
Metadaten
Titel
Transoral endoscopic thyroid surgery in a Korean population
verfasst von
Jun-Ook Park
Angkoon Anuwong
Mi Ra Kim
Dong-Il Sun
Min-Sik Kim
Publikationsdatum
28.05.2019
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 7/2019
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6481-9

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