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Chen J, Bm BX, Bm CZ, Ma C, Lu T. A controlled study of the hygienic technical evaluation of the transaxillary approach for inflation-free single-port lumpectomy versus conventional transcervical anterior open surgery in radical thyroid cancer resection. World J Surg Oncol 2024; 22:173. [PMID: 38937770 PMCID: PMC11210178 DOI: 10.1186/s12957-024-03445-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/16/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE To evaluate sanitary techniques for radical thyroid cancer surgery via the transaxillary approach without inflation single-port endoscopic surgery (TAWISES) and the conventional open anterior cervical approach (COACAS) in a controlled manner. METHODS This work was a retrospective analysis of the clinical data of 60 patients admitted to our hospital for unilateral radical thyroid cancer surgery between 01/2021 and 12/2022. The control group underwent COACAS (30 patients), and the experimental group underwent TAWISES (30 patients). The patients' operative time, intraoperative bleeding volume, 24-h postoperative pain index, drainage tube carrying time, hospitalization duration and complication rate were compared and analyzed. The patients were followed up for 3, 6 and 12 months postoperatively and evaluated based on numbness, muscular tightness, pain and other discomfort in the neck, as well as satisfaction with social adaptation and cosmetic incisions. The recurrence status was assessed for 1 year in both groups of patients. A questionnaire survey was conducted to assess patient acceptance of the two surgical approaches. The economic characteristics (cost-effectiveness and cost-utility) of the different approaches in our region were evaluated comprehensively. RESULTS The length of the incision, drainage tube carrying time and hospitalization duration were greater in the experimental group than in the control group (P < 0.05). The differences in complication rate, intraoperative bleeding volume, 24-h postoperative pain index and recurrence rate were not statistically significant between the two groups (P > 0.05). Neck discomfort was greater in the control group, and the difference was statistically significant at the 3-month postoperative follow-up (P < 0.05). The differences at the 6- and 12-month postoperative follow-ups were not statistically significant (P > 0.05). However, mild discomfort was significantly more common in the experimental group (63.33% > 36.67%, 80% > 53.33%, P < 0.05). The experimental group had better social adaptability, greater total medical costs, and better overall patient medical satisfaction than did the control group (P < 0.05). The acceptance of TAWISL was greater than that of COACAS (P < 0.05). CONCLUSION Compared with COACLAS, TAWISES is safe and effective and better meets the cosmetic, psychological and social adaptation needs of patients. TAWISES is also more cost effective and can be better utilized for the population in our region, filling the gap in surgical modalities for thyroid cancer in in our region.
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Affiliation(s)
- Jie Chen
- Thyroid and Breast Surgery, Department of General Surgery, Wanbei Coal and Electricity Group General Hospital, Su Zhou, Anhui Province, China
| | - Bo Xu Bm
- Thyroid and Breast Surgery, Department of General Surgery, Wanbei Coal and Electricity Group General Hospital, Su Zhou, Anhui Province, China
| | - Chaojie Zhang Bm
- Thyroid and Breast Surgery, Department of General Surgery, Wanbei Coal and Electricity Group General Hospital, Su Zhou, Anhui Province, China
| | - Chengquan Ma
- Thyroid and Breast Surgery, Department of General Surgery, Wanbei Coal and Electricity Group General Hospital, Su Zhou, Anhui Province, China
| | - Tianwen Lu
- Thyroid and Breast Surgery, Department of General Surgery, Wanbei Coal and Electricity Group General Hospital, Su Zhou, Anhui Province, China.
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Chen J, Fang J, Liu J, Lu T, Zheng X, Wang S. Patient-reported oral function and psychological well-being outcomes of papillary thyroid cancer patients (PTC) after surgery: a cross-sectional study. Surg Endosc 2024; 38:813-820. [PMID: 38062180 DOI: 10.1007/s00464-023-10603-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/14/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND This study was performed to evaluate the differences in oral function and psychological well-being between patients with PTC after the gasless transoral endoscopic thyroidectomy vestibular approach (gasless-TOETVA) and patients with PTC after open surgery. METHODS PTC patients who underwent radical surgery from May 2021 to August 2022 were included in this study. Postoperative data on oral function and psychological well-being, including the Oral Health Impact profile-14 (OHIP-14) and State-Trait Anxiety Inventory Form Y, were collected and analyzed. RESULTS 212 patients were included in the analysis. Among them, 102 patients who received gasless-TOETVA were assigned to the gasless-TOETVA group, while the remaining 110 patients who underwent open surgery were categorized as the open group. Although the OHIP-14 score in the gasless-TOETVA group was higher than that of the open group from 6 months to 1 year after surgery (p = 0.012), the difference in OHIP-14 scores between the two groups disappeared 1 year after surgery (p = 0.155). There were no differences between the gasless-TOETVA group and the open group in state-anxiety scores. However, the gasless-TOETVA group had significantly lower trait-anxiety scores than the open group at all follow-up time periods. Furthermore, within the gasless-TOETVA group, patients who were more than 1 year post-surgery showed significantly increased trait-anxiety scores compared to those of patients who were less than 1 year post-surgery (Δ = 3.4; p = 0.032). In contrast, the open group showed a decreasing trend in trait-anxiety scores, but there was no statistically significant difference between patients who had surgery less than 1 year ago and those who had surgery more than 1 year ago (Δ = - 2.2; p = 0.094). CONCLUSION Gasless TOETVA had a temporary impact on oral function, but it did not alleviate the state of anxiety. Furthermore, we observed a significant increase in trait-anxiety scores among PTC patients who underwent gasless-TOETVA after 1 year.
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Affiliation(s)
- Jiaolong Chen
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Department of Head and Neck Surgery, Anhui Provincial Cancer Hospital, Hefei, China
| | - Jing Fang
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Department of Head and Neck Surgery, Anhui Provincial Cancer Hospital, Hefei, China
| | - Jianjun Liu
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Department of Head and Neck Surgery, Anhui Provincial Cancer Hospital, Hefei, China
| | - Tianya Lu
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Department of Head and Neck Surgery, Anhui Provincial Cancer Hospital, Hefei, China
| | - Xucai Zheng
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
- Department of Head and Neck Surgery, Anhui Provincial Cancer Hospital, Hefei, China.
| | - Shengying Wang
- Department of Head and Neck Surgery, West District of The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
- Department of Head and Neck Surgery, Anhui Provincial Cancer Hospital, Hefei, China.
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Yuan Y, Pan B, Tang E, Mo H, Zhu J, Yi Z, Lu D, Yin T, Sun Y, Yin S, Yang Z, Zhang F. Surgical methods of total thyroidectomy for differentiated thyroid cancer: a systematic review and Bayesian network meta-analysis. Int J Surg 2024; 110:529-540. [PMID: 37916941 PMCID: PMC10793844 DOI: 10.1097/js9.0000000000000819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Emerging remote-access surgical methods are utilized to treat differentiated thyroid cancer. The study aimed to compare the surgical integrity, safety, efficacy, and postoperative experience of patients among common surgical methods. METHODS The PubMed, Medline, Cochrane Library, Web of Science, and EMBASE databases were searched from their inception until March 2023. Pairwise meta-analysis and Bayesian network meta-analysis were performed. The surface under the cumulative ranking curve (SUCRA) was used to illuminate the probability that each method would be the best for each outcome. RESULTS Thirty-two studies comprising 7042 patients were included. Robotic bilateral axillo-breast approach (RBABA) and robotic gasless transaxillary approach (RGAA) retrieved fewer lymph nodes (LNs) than open thyroidectomy (OT). RBABA showed a significantly lower permanent recurrent laryngeal nerve (RLN) palsy rate than OT. According to SUCRA values, endoscopic transoral approach (EOA) ranked the highest in retrieved LNs (0.84), the proportion of stimulated serum thyroglobulin less than 1.0 ng/ml (0.77), and the pain score (0.77). Endoscopic bilateral areola approach (EBAA) ranked the highest in the transient RLN palsy rate (0.72). The endoscopic gasless transaxillary approach (EGAA) ranked the highest in the transient hypoparathyroidism rate (0.78). RBABA ranked the highest in the rate of permanent RLN palsy (0.94) and hypoparathyroidism (0.77). OT ranked the highest in operative time (0.92). CONCLUSIONS Each surgical method of total thyroidectomy has benefits and limitations. EOA performed the best in maintaining surgical integrality and reducing the pain score, while taking a long operative time. Generally, RBABA showed the best advantage in protecting parathyroid glands and RLN but with the longest operative time. OT had the best advantage in operative time. Therefore, OT and EOA are ideal methods for patients with a higher risk of central LN metastasis. RBABA and EOA may not be suitable for elderly patients or those with high anesthesia risk.
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Affiliation(s)
- Yuquan Yuan
- Graduate School of Medicine, Chongqing Medical University
- Chongqing Institute Green and Intelligent Technology, Chinese Academy of Sciences
- Chongqing School, University of Chinese Academy of Sciences
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Bin Pan
- Graduate School of Medicine, Chongqing Medical University
- Chongqing Institute Green and Intelligent Technology, Chinese Academy of Sciences
- Chongqing School, University of Chinese Academy of Sciences
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Enjie Tang
- Epidemiology Department, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, People’s Republic of China
| | - Hongbiao Mo
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Junping Zhu
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Ziying Yi
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Dengwei Lu
- Graduate School of Medicine, Chongqing Medical University
- Chongqing Institute Green and Intelligent Technology, Chinese Academy of Sciences
- Chongqing School, University of Chinese Academy of Sciences
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Tingjie Yin
- Graduate School of Medicine, Chongqing Medical University
- Chongqing Institute Green and Intelligent Technology, Chinese Academy of Sciences
- Chongqing School, University of Chinese Academy of Sciences
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Yiceng Sun
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Supeng Yin
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Zeyu Yang
- Graduate School of Medicine, Chongqing Medical University
- Chongqing Institute Green and Intelligent Technology, Chinese Academy of Sciences
- Chongqing School, University of Chinese Academy of Sciences
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
| | - Fan Zhang
- Graduate School of Medicine, Chongqing Medical University
- Chongqing Institute Green and Intelligent Technology, Chinese Academy of Sciences
- Chongqing School, University of Chinese Academy of Sciences
- Department of Breast and Thyroid Surgery, Chongqing General Hospital
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Yap RV, Buenafe AA, Tankiatsy J, Bejasa MM, Mahani IN, Calayag G. Carbon dioxide embolism during transoral endoscopic thyroidectomy: A case report and literature review. Asian J Endosc Surg 2023; 16:774-780. [PMID: 37550828 DOI: 10.1111/ases.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 06/29/2023] [Indexed: 08/09/2023]
Abstract
The creation of the surgical space in transoral endoscopic thyroid surgery may put the anterior jugular vein at risk for injury and possibly lead to carbon dioxide (CO2 ) embolism. Although rare, CO2 embolism is potentially fatal. We report a case of a 67-year-old female who underwent transoral endoscopic thyroidectomy vestibular approach (TOETVA) for a benign thyroid disease. Intraoperatively, the anterior jugular vein was inadvertently lacerated. The end-tidal (Et)CO2 , O2 saturation, heart rate, and blood pressure suddenly decreased. The patient eventually became asystole. Cardiopulmonary resuscitation was performed with a return of spontaneous circulation (ROSC). We successfully ligated the injured vessel and terminated the procedure. A literature review of CO2 embolism during transoral thyroid surgery is presented, focusing on presentation, management, and prevention. Since TOETVA is still in preliminary clinical application, especially in developing countries, CO2 embolism may not be uncommon during the initial phase of the learning curve. Surgeons and anesthesiologist should be aware of this possibility.
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Affiliation(s)
- Ralph Victor Yap
- Unified Minimally Invasive Surgery Training, Quezon City, Philippines
| | - Alfred Allen Buenafe
- Unified Minimally Invasive Surgery Training, Quezon City, Philippines
- Philippine Center for Advanced Surgery, Cardinal Santos Medical Center, San Juan, Philippines
- Section of Minimally Invasive Surgery, Cardinal Santos Medical Center, San Juan, Philippines
| | - James Tankiatsy
- Unified Minimally Invasive Surgery Training, Quezon City, Philippines
| | | | | | - Glenford Calayag
- Unified Minimally Invasive Surgery Training, Quezon City, Philippines
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Sun R, Wang X, Malouta MZ, Zhou Y, Cai Y, Shui C, Jiang J, Sheng J, Zheng C, Tian W, Li C. Construction of a system for head and neck tumor traceless resection with non-inflatable transaxillary total endoscopic surgery. World J Surg Oncol 2023; 21:221. [PMID: 37491247 PMCID: PMC10369686 DOI: 10.1186/s12957-023-03033-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/11/2023] [Indexed: 07/27/2023] Open
Abstract
Radical cure and functional preservation of tumors are the fundamental goals of surgical treatment of head and neck tumors, and the preservation of good aesthetics is a higher pursuit on this basis. Fully hiding the surgical incision and reducing the visibility of scars are important goals of cosmetic surgery. Using complete endoscopy for the head and neck is an effective method. CO2-free transaxillary total endoscopic surgery is a method with many advantages, which has been widely used in the resection of thyroid tumors, but for other parts and types of tumors in the head and neck, this surgical method is rarely used. The research team expanded its application scope and applied it to submandibular gland tumor resection and other head and neck surgeries for the first time. Through this exploration, it improved traction devices such as retractors, strictly limited the surgical indications, analyzed and summarized the key points, steps and methods of surgery, and built a treatment system for head and neck tumor surgery under complete endoscopy using the non-inflatable transaxillary approach. In this article, we introduce the system and select typical cases to share.
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Affiliation(s)
- Ronghao Sun
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, Chengdu, China
| | - Xu Wang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, Chengdu, China
| | - Michelle Z Malouta
- Department of Psychiatry, Bloomington Meadows Hospital, 3600 N Prow Rd, Bloomington, IN, 47404, USA
| | - Yuqiu Zhou
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, Chengdu, China
| | - Yongcong Cai
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, Chengdu, China
| | - Chunyan Shui
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, Chengdu, China
| | - Jian Jiang
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, Chengdu, China
| | - Jianfeng Sheng
- Department of Thyroid, Head, Neck and Maxillofacial Surgery, The Third People's Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Chuanming Zheng
- Department of Head and Neck Surgery, Center of Otolaryngology-Head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, China
| | - Wen Tian
- Department of General Surgery, Chinese PLA General Hospital, Beijing, China
| | - Chao Li
- Department of Head and Neck Surgery, Sichuan Cancer Hospital, Sichuan Cancer Institute, Sichuan Cancer Prevention and Treatment Center, Cancer Hospital of University of Electronic Science and Technology School of Medicine, Chengdu, China.
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Lu Q, Zhu X, Wang P, Xue S, Chen G. Comparisons of different approaches and incisions of thyroid surgery and selection strategy. Front Endocrinol (Lausanne) 2023; 14:1166820. [PMID: 37529600 PMCID: PMC10390217 DOI: 10.3389/fendo.2023.1166820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/13/2023] [Indexed: 08/03/2023] Open
Abstract
To date, the traditional open thyroid surgery via a low collar incision remains the standard approach for patients undergoing thyroidectomy. However, this conventional approach will inevitably leave patients a neck scar and even cause a variety of complications such as paresthesia, hypesthesia, and other uncomfortable sensations. With the progress in surgical techniques, especially in endoscopic surgery, and the increasing desire for cosmetic and functional outcomes, various new approaches for thyroidectomy have been developed to avoid or decrease side effects. Some of these alternative approaches have obvious advantages compared with traditional surgery and have already been widely used in the treatment of thyroid disease, but each has its limitations. This review aims to evaluate and compare the different approaches to thyroidectomy to help surgeons make the proper treatment strategy for different individuals.
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Ludwig B, Ludwig M, Dziekiewicz A, Mikuła A, Cisek J, Biernat S, Kaliszewski K. Modern Surgical Techniques of Thyroidectomy and Advances in the Prevention and Treatment of Perioperative Complications. Cancers (Basel) 2023; 15:cancers15112931. [PMID: 37296896 DOI: 10.3390/cancers15112931] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
Thyroid cancer is the most common cancer of the endocrine system, and, in recent years, there has been a phenomenon of overdiagnosis followed by subsequent overtreatment. This results in an increasing number of thyroidectomy complications being faced in clinical practice. In this paper, we present the current state of knowledge and the latest findings in the fields of modern surgical techniques, thermal ablation, the identification and assessment of parathyroid function, recurrent laryngeal nerve monitoring and treatment and perioperative bleeding. We reviewed 485 papers, from which we selected 125 papers that are the most relevant. The main merit of this article is its comprehensive view of the subject under discussion-both general, concerning the selection of the appropriate method of surgery, and particular, concerning the selection of the appropriate method of prevention or treatment of selected perioperative complications.
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Affiliation(s)
- Bartłomiej Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Maksymilian Ludwig
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Anna Dziekiewicz
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Agnieszka Mikuła
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Jakub Cisek
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Szymon Biernat
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Krzysztof Kaliszewski
- Department of General, Minimally Invasive and Endocrine Surgery, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
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Li P, Qin H, Jin R, Zheng W, Fan P, Lyu PF. The global status and hotspots of research in the field of trans-oral endoscopic thyroidectomy (TOET) from 2008 to 2022. Front Surg 2023; 10:1120442. [PMID: 37181597 PMCID: PMC10174433 DOI: 10.3389/fsurg.2023.1120442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/20/2023] [Indexed: 05/16/2023] Open
Abstract
Purpose In this study, the aim was to comprehensively analyze the current status, hotspots, and trends of trans-oral endoscopic thyroidectomy (TOET) through bibliometric analysis and by presenting the field atlas. Methods Web of Science Core Collection database was adopted to screen studies regarding TOET published between January 1, 2008 and August 1, 2022. The evaluation covered the criteria total number of studies, keywords, and contributions from countries/regions, institutions, journals, and authors. Results A total of 229 studies were covered. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES is the largest publication in the field of TOET. The three countries that contributed the most studies were Korea, China, and the USA. The most frequently occurring core keywords in the field of TOET are vestibular approach, outcomes, experience, safety, robotic thyroidectomy, scar, video-assisted thyroidectomy and quality-of-life. The seven clusters were generated in this study: intraoperative monitoring of the laryngeal return nerve (# 0), learning curve (# 1), postoperative quality of life (# 2), central lymph node dissection and safety (# 3), complications (# 4), minimally invasive surgery (# 5), and robotic surgery (# 6). Conclusion The main research topics in the field of TOET place focuses on learning curves, laryngeal nerve monitoring, carbon dioxide gas bolus, chin nerve injury, surgical complications, and surgical safety. In the future, more academics will focus on the safety of the procedure and reducing complications..
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Affiliation(s)
- Ping Li
- Department of Maxillofacial and Ear, Nose and Throat Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Hao Qin
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Rui Jin
- Department of Maxillofacial and Ear, Nose and Throat Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, China
| | - Wuping Zheng
- Department of Thyroid and Breast Surgery, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
- Correspondence: Peng-fei Lyu Pingming Fan Wuping Zheng
| | - Pingming Fan
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
- Correspondence: Peng-fei Lyu Pingming Fan Wuping Zheng
| | - Peng-fei Lyu
- Department of Breast Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China
- Correspondence: Peng-fei Lyu Pingming Fan Wuping Zheng
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