A comparison of efficacy and quality of life between transoral endoscopic thyroidectomy vestibular approach (TOETVA) and endoscopic thyroidectomy axillo-breast approach (ETABA) in thyroid surgery: non-randomized clinical trial

Abstract

Purpose

Recently, there are many new surgical methods of endoscopic thyroidectomy, which have advantages in cosmetic results while do not increase the complication rates. This study was conducted to evaluate and compare both intra- and post-operative results and quality of life between TOETVA and endoscopic thyroidectomy axillo-breast approach (ETABA).

Materials and methods

A non-randomized, patient preference clinical trial was performed in Otorhinolaryngology, Head and Neck surgery department, HRH Princess Maha Chakri Sirindhorn Medical center. Patients who decided to go for endoscopic thyroidectomy were allocated into two groups. Demographics data, operative time, intra-operative blood loss, post-operative pain score, length of hospital stay, complications were collected. Overall satisfaction was evaluated by visual analogue scale and quality of life was evaluated by SF-36 questionnaires.

Results

22 patients were totally included and equally allocated in 2 groups (11 patients per group). All of the operations were lobectomy. There was no significant difference in demographic data. The results showed that pain score at 3 days post-operation and average pain score were significantly higher in TOETVA group. Average pain score was 3.67 ± 1.11 in ETABA group and 5.15 ± 1.35 in TOETVA (p = 0.011); however, the operative time, intra-operative blood loss, length of hospital stay, complications and overall satisfaction were not significantly different. Different change in the quality of life was not detected in both groups.

Conclusion

Transoral endoscopic thyroidectomy vestibular approach and ETABA both have comparable results and do not worsen the quality of life.

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Funding

This study was supported by a research grant from HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University. No financial and no material support for this research and work. Funding was provided by Instituto Nacional de Ciência e Tecnologia em Medicina Assistida por Computação Científica (BR) (Grant no. 596/2562).

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All authors met the criteria for authorship established by the International Committee of Medical Journal Editors, specifically: Panuwat Wongwattana, Pawin Laoveerakul and Alena Santeerapharp were responsible for substantial contribution to the conception, design, and drafting the work, revising the work and reviewing the manuscript. Additionally, all authors provided final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring including the accuracy and/or integrity of the work.

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Correspondence to Alena Santeerapharp.

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Authors have no financial interests in any companies or other entities that have an interest in the information in the contribution (e.g., grants, advisory boards, employment, consultancies, contracts, honoraria, royalties, expert testimony, partnerships, or stock ownership in medically related fields).

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Wongwattana, P., Laoveerakul, P. & Santeerapharp, A. A comparison of efficacy and quality of life between transoral endoscopic thyroidectomy vestibular approach (TOETVA) and endoscopic thyroidectomy axillo-breast approach (ETABA) in thyroid surgery: non-randomized clinical trial. Eur Arch Otorhinolaryngol (2021). https://doi.org/10.1007/s00405-021-06639-2

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Keywords

  • Endoscopic thyroidectomy
  • Thyroidectomy axillo-breast approach
  • Thyroidectomy vestibular approach
  • Satisfaction
  • Quality of life