Bi-institutional experience of transoral endoscopic thyroidectomy: Challenges and outcomes

Background: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel remote-access endoscopic approach. In this study, we compared the surgical outcomes of TOETVA with those of conventional transcervical approach (TCA) in two tertiary hospitals. Methods: A total of 82 patients were done by TOETVA and 233 patients received TCA between January 2018 and April 2019. Propensity score matching was used to reduce selection bias. Results: Operation time of the TOETVA group was longer than that of the TCA group. The mean number or retrieved lymph nodes were significantly higher in the TOETVA group. No significant difference was observed in the overall perioperative complications. Conclusion: TOETVA is technically acceptable when compared to TCA in terms of equal baseline characteristics of patients. Although future large-scale multicenter studies with longer follow-up periods are needed, we expect this novel technique can be performed not only for cosmetic purposes but also for patients with papillary thyroid carcinoma.