Clinical efficacy of gasless submental-transoral endoscopic thyroidectomy with Kirschner wire suspension for papillary thyroid carcinoma

Purpose: To analyze the clinical efficacy of gasless submental-transoral endoscopic thyroidectomy (ETE) with Kirschner wire suspension in patients with papillary thyroid carcinoma (PTC). Methods: Retrospectively, we enrolled 112 patients with PTC who received treatment in The Second Affiliated Hospital of Nanchang University between December 2020 and December 2021. Among them, 60 cases (laparoscopic group) received gasless submental-transoral ETE with Kirschner wire suspension, and the other 52 cases (open group) were treated by traditional thyroidectomy. Surgical indicators (operative time (OT), intraoperative blood loss (IBL), and postoperative drainage volume (DV)), number of central lymph node (CLN) dissected, length of hospital stay (LOS), Visual Analogue Scale (VAS) score, aesthetic satisfaction score, and complications were observed and compared between the two groups. Results: There was no significant difference between the two groups in OT (55.73 +/- 5.49 min vs. 55.00 +/- 7.79 min), IBL (20.67 +/- 7.75 mL vs. 23.08 +/- 6.24 mL), postoperative DV (33.17 +/- 15.09 mL vs. 39.52 +/- 19.22 mL), number of CLN dissected (5.54 +/- 2.75 vs. 5.43 +/- 3.15), LOS (3.63 +/- 0.69 d vs. 3.68 +/- 0.57 d), postoperative VAS score (3.19 +/- 1.07 points vs. 3.38 +/- 1.09 points), and total complication rate (3.85% vs. 8.33%; all P>0.05). However, the laparoscopic group exhibited a significantly higher aesthetic satisfaction score than the open group (7.10 +/- 1.46 points vs. 6.42 +/- 1.46 points; P<0.05). In addition, patients in both groups were followed up for at least 3 months, and no recurrence or metastasis was observed. Conclusions: Gasless submental-transoral ETE with Kirschner wire suspension offers comparable curative effect as traditional thyroidectomy and safety, but it provides superior esthetic results, making it a viable treatment option for patients with PTC.