Our Summary

This research paper analyzes the outcomes and complications of two types of thyroid surgeries: transoral thyroidectomy vestibular approach (TOTVA) and conventional open thyroidectomy (COT). The researchers looked at data from multiple sources, including PUBMED, EMBASE, the Cochrane Library, and Web of Science, covering studies from 2007 to 2022. They included 15 studies in their analysis, which involved a total of 2955 patients.

The researchers found that TOTVA surgeries generally took longer, resulted in more blood loss, and had a higher rate of wound infections than COT surgeries. However, there wasn’t a significant difference between the two methods when it came to complications involving the recurrent laryngeal nerve (a nerve that can be damaged during thyroid surgery) and other postoperative outcomes.

Despite the slightly higher risks, the researchers concluded that TOTVA is a viable and safe option for treating benign (non-cancerous) thyroid nodules and certain types of thyroid cancer, similar to the traditional COT method.

FAQs

  1. What are the two types of thyroid surgeries analyzed in the research paper?
  2. How do the outcomes and complications of transoral thyroidectomy vestibular approach (TOTVA) and conventional open thyroidectomy (COT) compare?
  3. Is TOTVA a safe option for treating benign thyroid nodules and certain types of thyroid cancer?

Doctor’s Tip

One helpful tip a doctor might tell a patient about thyroidectomy is to follow post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and avoiding strenuous activities that could strain the surgical site. It is also important to monitor for any signs of infection, such as fever, redness, or swelling, and to report any new or worsening symptoms to your healthcare provider promptly. By following these guidelines, patients can help ensure a smooth and successful recovery following thyroid surgery.

Suitable For

Patients who are typically recommended for thyroidectomy include those with:

  1. Thyroid cancer: Patients with thyroid cancer may require thyroidectomy as part of their treatment plan to remove the cancerous tissue.

  2. Large or symptomatic thyroid nodules: Thyroid nodules that are causing symptoms such as difficulty swallowing, breathing, or speaking, or are significantly enlarging, may require surgical removal.

  3. Hyperthyroidism: Patients with hyperthyroidism, especially those who do not respond to other treatments such as medication or radioactive iodine therapy, may be recommended for thyroidectomy.

  4. Recurrent thyroid nodules: Patients with recurrent thyroid nodules that continue to grow or cause symptoms despite previous treatments may be candidates for thyroidectomy.

  5. Graves’ disease: In some cases, patients with Graves’ disease, an autoimmune disorder that causes hyperthyroidism, may require thyroidectomy as a treatment option.

  6. Suspicious or indeterminate thyroid nodules: Patients with thyroid nodules that are suspicious for cancer or have inconclusive biopsy results may be recommended for thyroidectomy for further evaluation and treatment.

Overall, the decision to recommend thyroidectomy is based on a thorough evaluation of the patient’s medical history, symptoms, diagnostic tests, and individual risk factors. It is important for patients to discuss the potential risks and benefits of thyroidectomy with their healthcare provider to make an informed decision about their treatment options.

Timeline

Timeline of a patient’s experience before and after thyroidectomy:

Before surgery:

  1. Patient visits a doctor and undergoes various tests such as blood tests, imaging studies, and possibly a biopsy to determine the need for surgery.
  2. Patient discusses the risks and benefits of thyroidectomy with their healthcare provider and decides to proceed with the surgery.
  3. Patient may need to undergo pre-operative preparation, such as fasting before surgery and stopping certain medications.

During surgery:

  1. Patient undergoes either TOTVA or COT thyroidectomy under general anesthesia.
  2. Surgery typically lasts a few hours, depending on the complexity of the case.
  3. The surgeon removes part or all of the thyroid gland, depending on the reason for surgery.

After surgery:

  1. Patient is monitored in the recovery room for a few hours before being transferred to a hospital room or discharged home.
  2. Patient may experience pain, swelling, and difficulty swallowing in the days following surgery.
  3. Patient will need to take thyroid hormone replacement medication for the rest of their life if the entire thyroid gland is removed.
  4. Patient will have follow-up appointments with their healthcare provider to monitor their thyroid hormone levels and overall health.
  5. Patient may experience complications such as infection, bleeding, or damage to the recurrent laryngeal nerve, which can cause voice changes or difficulty speaking.

Overall, thyroidectomy is a common and generally safe procedure for treating various thyroid conditions. Patients should discuss the risks and benefits of surgery with their healthcare provider and follow their post-operative care instructions closely to ensure a successful recovery.

What to Ask Your Doctor

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

  1. What are the risks and benefits of TOTVA compared to COT for my specific condition?
  2. How experienced are you in performing TOTVA surgeries?
  3. What is the expected recovery time and postoperative care for TOTVA compared to COT?
  4. What are the potential complications of TOTVA surgery, and how are they managed?
  5. Will I need to take any medications or undergo additional treatments after TOTVA surgery?
  6. How will TOTVA surgery affect my thyroid function and overall health in the long term?
  7. Are there any specific lifestyle changes or restrictions I should follow after TOTVA surgery?
  8. What is the success rate of TOTVA surgery for treating my specific thyroid condition?
  9. How will follow-up appointments and monitoring be conducted after TOTVA surgery?
  10. Are there any alternative treatment options to consider before proceeding with TOTVA surgery?

Reference

Authors: Zhou S, Wang D, Liu X, Li Z, Wang Y. Journal: Endocrine. 2023 Jul;81(1):36-46. doi: 10.1007/s12020-023-03321-x. Epub 2023 Feb 24. PMID: 36826685