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Publications

Journal Article Ahead of print

PubMed: 41762587 DOI: 10.1016/j.oraloncology.2026.107908

Surgical outcomes of modified versus conventional transoral endoscopic thyroidectomy vestibular approach for papillary thyroid carcinoma.

Oral Oncol 175:107908

Authors: Duy Quoc Ngo, Duong The Le, Quy Xuan Ngo, Quang Van Le

Affiliations

  • Vietnam National Cancer Hospital, 30 Cau Buou Street, Hanoi, Viet Nam; Department of Oncology, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, Viet Nam.
  • Vietnam National Cancer Hospital, 30 Cau Buou Street, Hanoi, Viet Nam.
  • Vietnam National Cancer Hospital, 30 Cau Buou Street, Hanoi, Viet Nam; Department of Oncology, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, Viet Nam.

Abstract

BACKGROUND

Transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) offers superior cosmetic outcomes but is associated with prolonged operative time and mental nerve injury. We have implemented a modified TOETVA technique and compared its surgical outcomes with the conventional approach in early-stage papillary thyroid carcinoma (PTC).

METHODS

This retrospective study included 505 consecutive patients with T1aN0M0 PTC who underwent TOETVA hemithyroidectomy with ipsilateral central neck dissection between January 2022 and March 2025. Patients were divided into conventional (n = 447) and modified (n = 58) TOETVA groups. Propensity score matching (1:2) was performed based on age, sex, tumor size, and tumor location. Operative time, postoperative pain, length of hospital stay, and complications were compared.

RESULTS

After matching, 150 patients were analyzed (92 conventional vs. 58 modified). The modified group demonstrated a significantly shorter operative time (67.84 ± 6.36 vs. 84.78 ± 13.18 min; p < 0.001) and hospital stay (2.62 ± 0.56 vs. 3.86 ± 1.13 days; p < 0.001). Postoperative pain scores were significantly lower in the modified group on postoperative days 1, 3, and 5 (all p < 0.001). The incidence of transient mental nerve injury was reduced (1.7% vs. 9.8%; p = 0.032). No patients required conversion to open surgery or experienced permanent recurrent laryngeal nerve injury or permanent hypoparathyroidism.

CONCLUSIONS

The modified TOETVA technique is a safe and effective alternative for early-stage PTC. It may improve perioperative outcomes while maintaining a low complication rate.

MeSH

Thyroid Cancer, Papillary, Pain, Neoplasms, Thyroid Gland, Operative Time, Thyroidectomy