Prophylactic antibiotics may not be necessary for transoral endoscopic thyroidectomy

Area of Science:

• Endocrine Surgery
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Transoral endoscopic thyroidectomy (TOET) is gaining popularity globally due to advances in surgical techniques and patient cosmetic concerns.
• The classification of TOET as a clean-contaminated surgery requires further investigation.

Purpose of the Study:

• To determine if transoral endoscopic thyroidectomy (TOET) qualifies as a clean-contaminated surgical procedure.
• To assess the risk of bacterial contamination and surgical site infections associated with TOET.

Main Methods:

• A prospective study involving 20 patients undergoing TOET for thyroid cancer between September 2016 and April 2018.
• Oral cavity cultures were obtained preoperatively and postoperatively.
• Patients received prophylactic antibiotics before and after surgery.

Main Results:

• No surgical site infections were observed in any of the 20 patients.
• Bacterial presence in oral cultures showed no significant difference between pre- and postoperative samples.
• All identified bacteria were normal oral or skin flora, indicating no pathogenic invasion.

Conclusions:

• Transoral endoscopic thyroidectomy (TOET) does not appear to be a clean-contaminated surgery based on bacterial culture results.
• Prophylactic antibiotic use and the surgical approach likely minimize the risk of bacterial contamination and infection.
• The anatomical position and surgical extent in TOET create a barrier against non-indigenous bacterial invasion.