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. 2022 Jan-Feb;36(1):1-12.
doi: 10.21873/invivo.12671.

Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review

Ellada Akritidou  1   2 , Gerasimos Douridas  3 , Eleftherios Spartalis  2   4 , Gerasimos Tsourouflis  2   4 , Dimitrios Dimitroulis  2   4 , Nikolaos I Nikiteas  2   4
Affiliations

Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review

Ellada Akritidou et al. In Vivo. 2022 Jan-Feb.

Abstract

This review focuses on complications linked to trans-oral endoscopic thyroidectomy via vestibular approach (TOETVA) and aimed to elucidate the procedure's initial safety profile. According to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), Pubmed, Embase, and the Cochrane databases were screened till May 2021. Twenty-eight articles, nine cohorts and nineteen case series, met the inclusion criteria. Procedure-related complications were analyzed, the most important being hypoparathyroidism: transient (range=0.94-22.2%), permanent (range=1.33-2.22%), and recurrent laryngeal nerve injury: transient (range=1.9-8.8%) and permanent (range=0.59-1.42%). Surgical trauma related complications, the most prevalent being seroma, emphysema, and hematoma accounted for 2.91%. Null mortality was reported. Although current evolving experience indicates that TOETVA is safe and linked to acceptable complication rates, the method needs to be compared with the gold standard of traditional thyroidectomy in the context of sufficiently numbered cohorts and ultimately randomized controlled trials.

Keywords: TOETVA; TORTVA; Trans-oral; complications; minimal invasive thyroid surgery; review; thyroid surgery; vestibule.

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Conflict of interest statement

The Authors declare that they have no conflicts of interest in relation to this study.

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Figure 1. Flowchart: selection of articles.
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