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Publications

Journal Article Ahead of print

PubMed: 42385551 DOI: 10.1016/j.oraloncology.2026.108061

Technical and therapeutic evaluation of endoscopic treatment of early papillary thyroid cancer through oral vestibular approach.

Oral Oncol 180:108061

Authors: Duy Quoc Ngo, Angkoon Anuwong, Duong The Le, Quy Xuan Ngo, Kyung Tae, 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.
  • Division of Minimally Invasive and Endocrine Surgery, Department of Surgery, Police General Hospital, Bangkok, Thailand.
  • Vietnam National Cancer Hospital, 30 Cau Buou Street, Hanoi, Viet Nam.
  • Vietnam National Cancer Hospital, 30 Cau Buou Street, Hanoi, Viet Nam.
  • Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, the Republic of Korea.
  • 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

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is an innovative scarless surgical technique for thyroid carcinoma. However, there is limited safety data from extensive experiences in single institutions. This study evaluates the safety and outcomes of TOETVA through a large-scale, single-institution experience.

METHODS

We conducted a retrospective cohort study of 612 consecutive patients with papillary thyroid carcinoma who underwent TOETVA between January 2019 and February 2025. The primary endpoints were operative safety and complication rates.

RESULTS

The cohort predominantly consisted of females (95.6%) with a mean age of 32.7 years. Procedures included 580 hemithyroidectomies (94.8%) and 32 total thyroidectomies (5.2%), all with central neck dissection. The mean operative time was 86.9 min, and the conversion rate to open surgery was 0.3%. Temporary recurrent laryngeal nerve dysfunction occurred in 4.7% of patients, while permanent injury was recorded in 0.4%. Among total thyroidectomy cases, 15.6% experienced temporary hypocalcemia, with no permanent cases. Transient mental nerve dysfunction affected 8.8% of patients, all resolving within 3 months. With a mean follow-up of 31.9 months, only one patient (0.16%) experienced regional recurrence.

CONCLUSIONS

This large series suggests that TOETVA is a safe and effective surgical approach for carefully selected patients with papillary thyroid carcinoma. However, these findings are derived from a highly selected low-risk population and should not be generalized to older patients, larger tumors, aggressive histologic variants, or clinically advanced disease.

MeSH

Thyroid Cancer, Papillary, Safety, Neoplasms, Thyroid Gland, Thyroid Neoplasms, Therapeutics, Thyroidectomy