Thanadeth Vongjarukorn, MD, Khwannara Ketwong, MD, Isariya Jongekkasit, MD, Pornpeera Jitpratoom, MD, Thanyawat Sasanakietkul, MD, Angkoon Anuwong, MD. Police General Hospital
Introduction: Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA)’s an upcoming surgical technique. There’re total of 680 TOETVA cases performed in Police General Hospital from March 2014 – July 2017. There’s still less report about thyroid cancer cases in TOETVA. This study reviews all cases of thyroid cancer which surgery were performed. There were 47cases of TOETVA in thyroid cancer and 7cases of opened thyroidectomy.
Objective: To review and report in terms of surgical outcome, complication, post-surgical treatment and recurrence in all cases of thyroid cancer surgery, especially in TOETVA technique.
Material and Methods: From March 2014 – July 2017 in Police General Hospital, a total of 680 patients underwent TOETVA with 47cases of TOETVA in thyroid cancer and 7cases of opened thyroid surgery in thyroid cancer. All patients were recorded in multiple parameters.
Results: This study have total of 54 thyroid cancer cases which 7cases (13%) were male and 47cases (87%) were female, with an average age of 38.
Most clinical presentation was thyroid mass or nodule which was at 52cases (96.3%), 1case (3.7%) was non -toxic goiter and 1case (3.7%) was Grave disease. The clinical presentation mean time was 2.6years (2weeks-13years). There were 36cases (66.7%) with a mass at right lobe, 15cases (27.8%) with a mass at left lobe, and 3cases (5.6%) with mass at both lobes. The size of thyroid mass was 3.5 ±2.3centimeters (1-15centimeters). There were 49cases (90.7%) had euthyroid, 1case (1.85%) had subclinical hyperthyroid, 2cases (3.7%) had subclinical hypothyroid, and 2cases (3.7%) had hyperthyroid.
For type of surgery, there were 47cases (87.04%) of TOETVA surgery and 7cases (12.96%) of opened total thyroidectomy. Most patients at 41cases (75.9%) didn't have any post-operative complication. And there were hypothyroid 5cases (9.35%), transient hypocalcemia with no symptom 6cases (11.1%), and transient hoarseness 2cases (3.7%).
After TOETVA surgery performed, 24cases (44.4%) were redo completion thyroidectomy, 19cases (79.2%) were transaxillary completion thyroidectomy, 4cases (16.7%) were redo TOETVA, and 1case (4.2%) deny for re-operation. And 18cases (75%) didn’t have any complication after redo surgery, 3cases (12.5%) were hypothyroid, 2cases (8.32%) were hypocalcemia and hypoparathyroid, and 1case (4.2%) was transient hoarseness.
After did thyroidectomy, ultrasound neck shown that 47cases had no residual or recurrence thyroid mass, 7cases had residual thyroid tissue. All cases received radioactive iodine ablation. Radionuclide total body scan showed no evidence of distant functioning metastasis.
Conclusion: Three-year short-term followed up TOETVA in thyroid cancer has shown less complication and no recurrence cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87056
Program Number: P676
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster