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. 2018 Nov 14;45(5):e1951.
doi: 10.1590/0100-6991e-20181951.

Transoral endoscopic thyroidectomy by vestibular approach (TOETVA): initial experience in Brazil

[Article in Portuguese, English]
Marco Antonio Scirea Tesseroli  1 , Mauricio Spagnol  2 , Álvaro Sanabria  3
Affiliations
Free article

Transoral endoscopic thyroidectomy by vestibular approach (TOETVA): initial experience in Brazil

[Article in Portuguese, English]
Marco Antonio Scirea Tesseroli et al. Rev Col Bras Cir. .
Free article

Abstract
in English, Portuguese

Objective: to present the initial experience in Brazil with transoral endoscopic thyroidectomy by vestibular approach (TOETVA).

Methods: prospective study of patients undergoing TOETVA in the Department of Head and Neck Surgery of Hospital Regional do Oeste, Chapecó, Santa Catarina. Patients between 18 and 65 years of age, ASA I and II, with maximum glandular volume of 35cm3 and nodules up to 4cm were candidates for the study. Data of the patients, nodules, surgical time, complications, and length of hospital stay were recorded.

Results: nine patients were operated between May 2017 and April 2018. All were women, aged 33-64 years. The size of the nodule ranged from 1cm to 4cm. Two patients had malignant neoplasia and total thyroidectomy was performed in eight cases. Seven patients were hospitalized for only one day. One patient had a minor complication on skin, but there were no lesions of the laryngeal recurrent nerves or definitive hypoparathyroidism.

Conclusion: TOETVA is a safe technique for well-selected patients, with favorable conditions and special concern for aesthetic results.

Objetivo: apresentar a experiência inicial no Brasil com a tireoidectomia transoral endoscópica por abordagem vestibular (TOETVA).

Métodos: estudo prospectivo de pacientes submetidos à TOETVA no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Regional do Oeste, Chapecó, Santa Catarina. Foram candidatos para o estudo os pacientes entre 18 e 65 anos de idade, ASA I e II, com volume glandular de até 35cm3e nódulos de até de 4cm. Dados dos pacientes, dos nódulos, tempo cirúrgico, complicações, e tempo de internação foram registrados.

Resultados: nove pacientes foram operados entre maio de 2017 e abril de 2018. Todos eram mulheres, com idades entre 33 e 64 anos. O tamanho do nódulo variou de 1cm a 4cm. Dois pacientes eram portadores de neoplasia maligna e a tireoidectomia total foi feita em oito casos. Sete pacientes tiveram uma internação de apenas um dia. Um paciente sofreu uma complicação menor na pele, mas não ocorreram lesões dos nervos laríngeos recorrentes ou hipoparatireoidismo definitivo.

Conclusão: a TOETVA é uma técnica segura para pacientes bem selecionados, com condições favoráveis e com especial preocupação com resultados estéticos.

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