Transoral Endoscopic Thyroidectomy by Vestibular Approach for Papillary Thyroid Carcinoma with Tumor Size ≥2 cm

Background: The transoral endoscopic thyroidectomy by vestibular approach (TOETVA) has been developed for papillary thyroid carcinoma (PTC) treatment with satisfactory results. However, there were few malignant thyroid nodules >= 2 cm in previous studies of TOETVA. Therefore, we conducted this study to evaluate the results of treatment by TOETVA for PTC with tumor size >= 2 cm.Materials and Methods: The clinical characteristics and surgical outcomes of 10 PTC patients with tumor size >= 2 cm who underwent TOETVA in our center from June 2018 to August 2021 were, respectively, reviewed.Results: All 10 included PTC patients successfully underwent TOETVA and the mean tumor size was 2.5 +/- 0.5 cm. The mean number lymph nodes dissected was 9.6 +/- 2.9, and 3.1 +/- 3.3 positive lymph nodes were discovered. Postoperatively, transient hypoparathyroidism was recorded in 2 patients (20%), transient recurrent laryngeal nerve injury was noted in 1 patient (10%), transient superior laryngeal nerve injury was noted in 1 patient (10%), and numb chin was identified in 1 patient (10%). The postoperative complications aforementioned recovered within 6 months. During a median follow-up of 23.8 +/- 13.1 months, no other complications or tumor recurrence were found.Conclusions: TOETVA is feasible for PTC patients with tumor size >= 2 cm and satisfactory short-term surgical outcomes have achieved in this study. We suggested that experienced surgeons can gradually expand the indications for TOETVA.