Remote access and endoscopic thyroid surgery has been gaining popularity because it allows patients to avoid a visible scar in the neck. There is limited data on transoral endoscopic thyroidectomy when it relates to patients with papillary thyroid carcinoma. We aim to evaluate the safety of ipsilateral central compartment dissection for patients who undergo transoral thyroidectomy (thyroidectomy vestibular approach–compartment lymph node dissection). A total of 80 patients who underwent thyroidectomy vestibular approach–compartment lymph node dissection for papillary thyroid carcinoma from June 2015 to September 2016 were identified. Over the same period, a matched cohort of 80 patients who underwent open thyroidectomy with routine ipsilateral central compartment dissection was also identified (Open-compartment lymph node dissection). The two groups were analyzed in terms of patient characteristics, perioperative clinical results and post-operative outcomes. All patients were female with a mean age of 32-year. There was no difference in mean maximum tumor size and number of lymph nodes dissected. Moreover, there was no difference in average positive lymph nodes between thyroidectomy vestibular approach–compartment lymph node dissection and Open-compartment lymph node dissection (1.48 vs 1.08, P = 0.647). Operative time was longer in the thyroidectomy vestibular approach–compartment lymph node dissection group (193 vs 102 min, P < 0.001). Thyroidectomy specific complications were similar with rates of temporary recurrent laryngeal nerve palsy of 6.3 vs 8.8% and temporary hypocalcemia rates of 2.5 vs 5% in the thyroidectomy vestibular approach–compartment lymph node dissection and Open-compartment lymph node dissection groups, respectively. Thyroidectomy vestibular approach–compartment lymph node dissection is a feasible and safe option for select patients with papillary thyroid carcinoma who require central node dissection compared with Open-compartment lymph node dissection, and can be a viable alternative for patients wishing to avoid a visible scar.

Background: Endoscopic intervention through the natural foramen is becoming more and more interesting because of surgical treatment without any incision of the skin. In our center, transoral endoscopic thyroid surgery through vestibular approach (TOETVA) thyroid surgery may provide excellent results from a cosmetic viewpoint, which requires a learning curve. Generally, learning curve research for TOETVA could be benefit for investigating the surgical outcome for thyroid operation. Methods: This retrospective study investigated 204 consecutive patients, who underwent TOETVA performed by a single thyroid surgeon from November 2014 to June 2017. We divided the patients into hemithyroidectomy and total thyroidectomy, benign and malignant group. These groups were analyzed in terms of cut-suture time (CST) and cumulative sum (CUSUM) analysis, while accompanied with patient characteristics, perioperative clinical results, and operation-related complications. Results and Conclusions: The average CST of 204 cases was 147.99 ± 43.67 minutes. We observed that TOETVA enables a rapidly decreasing mean operative time after 40–50 cases to reach stabilized CST. Also, we compared the learning curve and CUSUM of the hemithyroidectomy and total thyroidectomy group, benign and malignant group, respectively.

Objective: To investigate the clinical efficacy and safety of endoscopic thyroidectomy through the oral vestibular approach and the breast approach. Methods: Retrospective analysis was done on clinical data of 80 patients who received an endoscopic thyroidectomy from April 2018 to March 2019. The research group had endoscopic thyroidectomy through the oral vestibular approach, whereas the control group had endoscopic thyroidectomy through the areola breast approach. Comparison between the two groups including intraoperative bleeding, operation time, total postoperative drainage, drainage time, postoperative sustained pain time, recovery feeding time, postoperative hospitalization duration, satisfactory esthetic outcomes of incision, central lymph node clearance, skin injury, infection incidence, and complications such as facial hematoma, subcutaneous emphysema, abnormal feeling of the neck and chest, and pleural injury was recorded. Results: There was no significant difference between the two groups in the amount of intraoperative bleeding, operation time, total postoperative drainage, drainage time, postoperative sustained pain time, recovery feeding time, and postoperative hospitalization time ( P > .05). The incidence of complications such as skin injury, infection, wound hematoma, subcutaneous emphysema, abnormal feeling of the neck and chest, and pleural injury was not statistically different between the two groups ( P > .05). There was no significant difference in the number of lymph nodes cleaned in the central area between the two groups ( P > .05). The overall satisfaction of the patients with the cosmetic effects of the incision (100.00%) was higher than that of the control group (90.00%). Conclusions: The clinical treatment effect and safety in the two groups were similar, but the transoral group had better cosmetic effects.

Background: This study aims to reveal regulatory role of cell division cycle associated 8 (CDCA8) in thyroid cancer progression and metastasis.