Transoral endoscopic selective lateral neck dissection for papillary thyroid carcinoma: a pilot study

Area of Science:

• Surgical Oncology
• Endoscopic Surgery
• Head and Neck Surgery

Background:

• Transoral endoscopic thyroid surgery via the vestibular approach (TOETVA) is gaining acceptance for its scarless neck outcome.
• While central lymphadenectomy is reported, lateral neck dissection with TOETVA is less documented.
• This study explores the feasibility of selective lateral neck dissection (SLND) using the transoral vestibular approach for papillary thyroid carcinoma (PTC).

Purpose of the Study:

• To evaluate the feasibility, safety, and efficacy of performing selective lateral neck dissection (SLND) for papillary thyroid carcinoma (PTC) via a transoral vestibular approach.
• To assess the outcomes and complications associated with this minimally invasive technique.

Main Methods:

• A prospective study involving 20 PTC patients with unilateral T1 tumors or abnormal lymph nodes underwent SLND via the transoral vestibular approach.
• The study was conducted between January 2016 and December 2018.
• Patients had unilateral T1 tumors without capsular invasion and/or abnormal level III and IV lymph nodes.

Main Results:

• Successful endoscopic surgery was achieved in all 20 patients.
• The mean operative time was 146.0 ± 18.7 minutes, with an average hospital stay of 6.8 ± 1.3 days.
• No major complications were reported, with only transient recurrent laryngeal nerve palsy and operative site effusions observed. Excellent cosmetic results and privacy were noted.

Conclusions:

• Endoscopic SLND via the transoral vestibular approach is a feasible, safe, and effective option for selected PTC cases.
• The technique provides excellent cosmetic outcomes and preserves patient privacy.
• Further multicenter, large-scale comparative studies are warranted to validate these findings.