Male Thyroid Cancer Patients Treated by Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA): Surgical...

Thyroid cancer is globally increasing, but it is rare and more aggressive in males. This study is aimed at preliminarily evaluating the effectiveness of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) in the treatment of thyroid cancer in male patients. A prospective study was conducted on 42 male thyroid cancer patients treated with TOETVA from January 2019 to December 2023 at Hanoi Medical University Hospital. All the patients enrolled had tumors < 2 cm in diameter, no extrathyroidal extension, and cN0 status. Surgical and oncologic outcomes were analyzed. The mean patient age was 30.2 (17-56) years, with 85.7% having solitary tumors, mostly in the left lobe (54.8%). Papillary thyroid carcinoma (95.2%) was the predominant diagnosis. An mean tumor size was 8.5 mm. Lobectomies comprised 95.2% of surgeries. The mean operative time was 83.3 (60-150) min, and blood loss was minimal 6.3 (5-15) ml. Postoperative complications included transient hoarseness (4.8%) and mouth-opening difficulty (2.4%), with no permanent severe hypocalcemia or hoarseness. No cases of completion thyroidectomy or conversion to open surgery due to TOETVA failure were recorded. On average, 3 (0-12) lymph nodes were harvested, with a median of 2 (0-8) malignant nodes. Most tumors were T1 (95.2%), and pN1a was observed in 52.4% of the cases. Patient satisfaction with cosmetic results was universally high. TOETVA is a safe and effective option for male patients with early-stage thyroid cancer, offering minimal complications and excellent cosmetic results. Further studies are needed to expand its application to broader population.