Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Endoscopic Thyroidectomy Via Areola Approach for Patients With Unilateral Papillary Thyroid Carcinoma: A Retrospective Study

Background: Endoscopic thyroidectomy via areola approach (ETA) has been widely used in thyroidectomy for many years as it can effectively avoid a scar in the neck. Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is newly applied and has gained popularity quickly. This study is to compare the safety and effectiveness of TOETVA and ETA. Materials and Methods: A total of 95 patients who underwent TOETVA or ETA with unilateral papillary thyroid carcinoma were enrolled in this study from March 2019 to February 2020. The basic information (such as gender, age), intraoperative hemorrhage, postoperative drainage volume, hospital durations, intraoperative and postoperative complications, operative time, central lymph node dissection time, total number of central lymph nodes, and number of metastatic central lymph nodes were compared. Results: The operative time of the TOETVA group was significantly longer than the ETA group (148.11 +/- 19.78 vs. 135.90 +/- 12.77 min, P< 0.05). However, the result was opposite when central lymph node dissection time was compared (10.31 +/- 2.93 vs. 12.48 +/- 3.55, P< 0.05). TOETVA had an advantage on total number of central lymph nodes over ETA (7.82 +/- 3.35 vs. 5.26 +/- 2.45, P< 0.05). No differences were found between the 2 groups on other data. Conclusion: TOETVA and ETA have the similarity on surgical safety and effectiveness. TOETVA has its advantage on central lymph node dissection and might be a reasonable alternative for ETA and open surgery in the future.