A Randomized Controlled Trial of Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) Versus Open Thyroidectomy: A Comparative Study of Efficacy and Complications
Satchachon Changthom
Department of Surgery, Mahasarakham Hospital, 168 Phadungwithi Road, Talat Subdistrict, Mueang District, Maha Sarakham 44000, Thailand; Email: [email protected]
บทคัดย่อ
ABSTRACT
Background: Minimally invasive thyroid surgery has evolved significantly, offering improved
cosmetic and clinical outcomes¹. Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA)
is a scar-free alternative to conventional open thyroidectomy (OT)². This study aims to compare the
safety and clinical outcomes of TOETVA and OT in patients with benign thyroid nodules, incorporating
data from a randomized controlled trial (RCT).
Methods: A single-blind randomized controlled trial was conducted on patients with thyroid
nodules ≤8 cm. Patients were randomized to undergo either TOETVA or conventional thyroidectomy.
Postoperative pain had been evaluated using VAS on days 1 and 2. A 3-month follow-up was performed
to evaluate complications, including recurrent laryngeal nerve (RLN) palsy, bleeding, and infection.
Results: Seventy patients were randomized to undergo either TOETVA or conventional
thyroidectomy. The baseline characteristics, including age and thyroid nodule size, were comparable
between groups. The mean operative time was longer in the TOETVA group (99 vs. 75 minutes, P <
0.001) and the pain score on the second postoperative day (0.74 vs. 1.86, P < 0.001). At the 3-month
follow-up, complications in the TOETVA group included one case of transient RLN palsy, one case of
mental nerve injury, and one case of subcutaneous emphysema. No complications were reported in
the OT group.
Conclusion: TOETVA is associated with reduced postoperative pain and improved cosmetic
outcomes compared to conventional thyroidectomy in the management of benign thyroid nodules.
 
ที่มา
Journal of the Association of General Surgeons of Thailand under the Royal Patronage of HM the King ปี 2568, ปีที่: 10 ฉบับที่ 3 หน้า 138-147
คำสำคัญ
Minimally invasive surgery, Benign thyroid nodules, Open thyroidectomy, Transoral endoscopic thyroidectomy vestibular approach (TOETVA)