Our Summary

The standard treatment for thyroid cancer is a surgery called open thyroidectomy, which leaves a visible neck scar and can negatively impact the patient’s quality of life. Recently, new surgical methods have been developed to avoid this neck scar: the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and transoral robotic thyroidectomy (TORT). These methods have shown positive results similar to open surgery for non-cancerous conditions and have also shown promise in a few cases of thyroid cancer. However, there are no data yet on how these methods perform in the long-term for thyroid cancer patients.

In this study, the researchers looked at the surgical results and mid-term cancer outcomes of TOETVA and TORT in patients with thyroid cancer. They analyzed data from patients who underwent these procedures between July 2017 and November 2021.

A total of 115 patients underwent 122 surgeries (57 TOETVAs and 65 TORTs). The surgeries included seven complete thyroidectomies for early-stage differentiated thyroid cancer. None of the surgeries had to be converted to the traditional open method.

The researchers found that TORT took longer than TOETVA, but there was no difference in complications between the two methods. Complete thyroidectomy using a second transoral approach was found to be safe.

The researchers also found that TOETVA and TORT had positive cancer outcomes. All patients survived and 98.2% had an acceptable response during an average follow-up period of about 38 months.

In conclusion, the researchers found that TOETVA and TORT are safe and have positive mid-term cancer outcomes for a selected group of patients with early-stage differentiated thyroid cancer.

FAQs

  1. What is the standard treatment for thyroid cancer and what are its downsides?
  2. What are the new surgical methods developed for thyroid cancer and how do they perform in comparison to open thyroidectomy?
  3. What were the findings of the study on TOETVA and TORT for patients with thyroid cancer?

Doctor’s Tip

Patients undergoing thyroidectomy should discuss with their doctor the possibility of using newer surgical methods like TOETVA and TORT to potentially avoid a visible neck scar and improve their quality of life. It is important to carefully consider the risks and benefits of these newer methods in consultation with a healthcare provider to determine the best treatment option for your individual case.

Suitable For

Therefore, patients with early-stage differentiated thyroid cancer who are looking to avoid a visible neck scar and maintain their quality of life may be good candidates for TOETVA or TORT. However, further research is needed to determine the long-term outcomes and efficacy of these methods for thyroid cancer patients.

Timeline

Before thyroidectomy:

  • Patient undergoes various tests and consultations to determine the need for surgery
  • Patient may need to prepare by adjusting medications or fasting before the procedure
  • Surgery is performed, either through open thyroidectomy or newer methods like TOETVA or TORT

After thyroidectomy:

  • Patient may experience pain, swelling, and difficulty swallowing in the immediate post-operative period
  • Patient may need to stay in the hospital for a few days for monitoring
  • Patient will need to take thyroid hormone replacement medication for life
  • Patient will need to follow up with their healthcare provider regularly for monitoring and potential further treatment
  • Patient may experience changes in voice, neck sensation, or appearance, depending on the surgical method used

Overall, the patient’s experience before and after thyroidectomy involves a series of consultations, tests, surgery, recovery, and long-term management to ensure optimal outcomes and quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about thyroidectomy include:

  1. What are the potential risks and complications associated with open thyroidectomy versus TOETVA or TORT?
  2. How long is the recovery process for each surgical method?
  3. Will I be left with a visible scar after the surgery, and if so, how noticeable will it be?
  4. How does the effectiveness of TOETVA or TORT compare to open thyroidectomy in treating thyroid cancer?
  5. Are there any specific criteria or limitations for being a candidate for TOETVA or TORT?
  6. What is the long-term outlook for thyroid cancer patients who undergo TOETVA or TORT compared to open thyroidectomy?
  7. Are there any additional follow-up or monitoring requirements for patients who undergo TOETVA or TORT?
  8. Will I need any additional treatments or therapies after undergoing TOETVA or TORT for thyroid cancer?
  9. How experienced is the medical team in performing TOETVA or TORT procedures for thyroid cancer?
  10. Are there any alternative treatment options or considerations I should be aware of before making a decision on which surgical method to choose?

Reference

Authors: Chen YH, Chao WP, Wang SH, Huang YT, Ng SC. Journal: Surg Endosc. 2023 Oct;37(10):7829-7838. doi: 10.1007/s00464-023-10339-9. Epub 2023 Aug 21. PMID: 37605012