Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluation
PurposeThe transoral endoscopic thyroidectomy vestibular approach (TOETVA) is distinguished by its ability to leave no visible scars on the body’s surface. Currently, there is still a lack of single-center large sample size analysis on the learning curve of TOETVA, especially for the treatment of th...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1498797/full |
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| author | Yuhang Deng Jiaojiao Zhao Mei Tao Haixin Zhao Ruoxin Fan Xiaoming Wang Xiubo Lu |
| author_facet | Yuhang Deng Jiaojiao Zhao Mei Tao Haixin Zhao Ruoxin Fan Xiaoming Wang Xiubo Lu |
| author_sort | Yuhang Deng |
| collection | DOAJ |
| description | PurposeThe transoral endoscopic thyroidectomy vestibular approach (TOETVA) is distinguished by its ability to leave no visible scars on the body’s surface. Currently, there is still a lack of single-center large sample size analysis on the learning curve of TOETVA, especially for the treatment of thyroid cancer. This study aims to fill this void by presenting a comprehensive analysis of the learning curve and assessing the procedure’s feasibility in managing thyroid cancer.MethodsBetween June 2020 and June 2023, a retrospective analysis was conducted on 195 patients who had undergone the transoral endoscopic thyroidectomy vestibular approach (TOETVA) at the First Affiliated Hospital of Zhengzhou University. We employed the cumulative sum method (CUSUM) to delineate the learning curve of TOETVA. Additionally, clinical parameters across different stages of the learning process were meticulously compared and analyzed.ResultsAll patients successfully completed endoscopic surgery without conversion to open surgery. Utilizing the CUSUM algorithm, two distinct learning phases were delineated: the exploration phase, comprising 58 cases, and the maturation phase, encompassing 137 cases. Analysis revealed that the maturation phase demonstrated significantly reduced operative times (189.7 ± 237.27 vs. 138.15 ± 26.62 minutes, p<0.001), decreased blood loss (15.49 ± 15.05 vs. 9.67 ± 4.12 ml, p=0.005), and a lower incidence of complications (7 vs. 4, p=0.028) when compared to the exploration phase. Additionally, in the maturation phase, we achieved successful surgical outcomes in a subset of obese patients and those with nodular goiter.ConclusionTOETVA has been demonstrated to be safe and feasible, with the capability to effectively address complex cases once the learning curve has been surmounted. |
| format | Article |
| id | doaj-art-b938c7aa95b64187958d703a329f6c3f |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-b938c7aa95b64187958d703a329f6c3f2025-01-06T06:59:30ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011510.3389/fendo.2024.14987971498797Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluationYuhang Deng0Jiaojiao Zhao1Mei Tao2Haixin Zhao3Ruoxin Fan4Xiaoming Wang5Xiubo Lu6Department of Thyroid Surgery, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, ChinaDepartment of Thyroid Surgery, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, ChinaOncology Department, Tianjin Medical University, Tianjin, ChinaDepartment of Thyroid Surgery, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, ChinaDepartment of Thyroid Surgery, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, ChinaDepartment of Thyroid Surgery, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, ChinaDepartment of Thyroid Surgery, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, ChinaPurposeThe transoral endoscopic thyroidectomy vestibular approach (TOETVA) is distinguished by its ability to leave no visible scars on the body’s surface. Currently, there is still a lack of single-center large sample size analysis on the learning curve of TOETVA, especially for the treatment of thyroid cancer. This study aims to fill this void by presenting a comprehensive analysis of the learning curve and assessing the procedure’s feasibility in managing thyroid cancer.MethodsBetween June 2020 and June 2023, a retrospective analysis was conducted on 195 patients who had undergone the transoral endoscopic thyroidectomy vestibular approach (TOETVA) at the First Affiliated Hospital of Zhengzhou University. We employed the cumulative sum method (CUSUM) to delineate the learning curve of TOETVA. Additionally, clinical parameters across different stages of the learning process were meticulously compared and analyzed.ResultsAll patients successfully completed endoscopic surgery without conversion to open surgery. Utilizing the CUSUM algorithm, two distinct learning phases were delineated: the exploration phase, comprising 58 cases, and the maturation phase, encompassing 137 cases. Analysis revealed that the maturation phase demonstrated significantly reduced operative times (189.7 ± 237.27 vs. 138.15 ± 26.62 minutes, p<0.001), decreased blood loss (15.49 ± 15.05 vs. 9.67 ± 4.12 ml, p=0.005), and a lower incidence of complications (7 vs. 4, p=0.028) when compared to the exploration phase. Additionally, in the maturation phase, we achieved successful surgical outcomes in a subset of obese patients and those with nodular goiter.ConclusionTOETVA has been demonstrated to be safe and feasible, with the capability to effectively address complex cases once the learning curve has been surmounted.https://www.frontiersin.org/articles/10.3389/fendo.2024.1498797/fulltransoral endoscopic thyroidectomy vestibular approachthyroid cancerlearning curvethyroidectomyminimally invasive surgery |
| spellingShingle | Yuhang Deng Jiaojiao Zhao Mei Tao Haixin Zhao Ruoxin Fan Xiaoming Wang Xiubo Lu Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluation Frontiers in Endocrinology transoral endoscopic thyroidectomy vestibular approach thyroid cancer learning curve thyroidectomy minimally invasive surgery |
| title | Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluation |
| title_full | Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluation |
| title_fullStr | Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluation |
| title_full_unstemmed | Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluation |
| title_short | Transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach: analysis of the learning curve and clinical outcomes evaluation |
| title_sort | transoral endoscopic thyroid lobectomy and ipsilateral central neck lymph node dissection vestibular approach analysis of the learning curve and clinical outcomes evaluation |
| topic | transoral endoscopic thyroidectomy vestibular approach thyroid cancer learning curve thyroidectomy minimally invasive surgery |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1498797/full |
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