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Publications

Journal Article Epublish

PubMed: 42536185 DOI: 10.1007/s00383-026-06555-8

Scarless thyroid surgery in children: a pediatric TOETVA cohort for differentiated thyroid carcinoma.

Pediatr Surg Int 42(1)

Authors: Duy Quoc Ngo, Anh Tuan Trinh, Duong The Le, Du Sy Truong, Thang Manh Hoang, Kyung Tae, Quang Van Le

Affiliations

  • Vietnam National Cancer Hospital, 30 Cau Buou Street, Thanh Liet Ward, Hanoi, Vietnam.
  • Hanoi Medical University, 01 Ton That Tung Street, Kim Lien Ward, Hanoi, Vietnam.
  • Vietnam National Cancer Hospital, 30 Cau Buou Street, Thanh Liet Ward, Hanoi, Vietnam.
  • Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.

Abstract

BACKGROUND/PURPOSE

Conventional open thyroidectomy leaves a visible cervical scar that can adversely affect the psychosocial well-being of pediatric patients. The transoral endoscopic thyroidectomy vestibular approach (TOETVA) offers a scarless alternative, but data regarding its application in pediatric malignancies remain scarce. This study aims to evaluate the surgical, cosmetic outcomes of TOETVA in pediatric patients with differentiated thyroid carcinoma (DTC).

METHODS

We retrospectively reviewed consecutive pediatric patients ([Formula: see text] 18 years) who underwent TOETVA for DTC (cT1N0M0) at a high-volume center between June 2020 and June 2026. Postoperative complications and cosmetic satisfaction were evaluated.

RESULTS

Twenty-six patients (mean age: 16.7 ± 1.9 years; 84.6% female) were enrolled. All procedures were successfully completed with a 0% conversion rate to open surgery. Twenty-four patients (92.3%) underwent thyroid lobectomy with isthmusectomy and prophylactic central neck dissection (CND) (mean operative time: 87.9 ± 9.5 min), while two (7.7%) underwent total thyroidectomy with CND (mean operative time: 132.5 min). Final histopathology confirmed papillary thyroid carcinoma in all cases. No major perioperative complications occurred. Transient adverse events included minor chin ecchymosis (11.5%), hoarseness (7.7%), and mental nerve injury (7.7%), all resolving completely within 3 months. No permanent recurrent laryngeal nerve injury, mental nerve dysfunction, or hypocalcemia was observed. Cosmetic outcomes were highly favorable, with all patients expressing excellent post-operative aesthetic satisfaction.

CONCLUSIONS

TOETVA appears to be a safe and feasible surgical approach for carefully selected pediatric patients with DTC. In this largest reported pediatric TOETVA series to date, the procedure achieved favorable surgical and cosmetic outcomes with low complication rates. TOETVA may therefore represent an effective scarless alternative for selected pediatric thyroid cancer when performed by experienced surgeons in high-volume centers.

MeSH

Cicatrix, Thyroid Gland, Operative Time, Thyroidectomy, Pediatrics, General Surgery, Child