Completion thyroidectomy via the transoral endoscopic vestibular approach
Completion thyroidectomy via the transoral endoscopic vestibular approach
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DOI：
10.21037/gs.2018.02.01
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发表时间：
2018-08-01
期刊：
影响因子：
1.8
通讯作者：
Russell, Jonathon O.
中科院分区：
文献类型：
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作者：
Razavi, Christopher R.;Tufano, Ralph P.;Russell, Jonathon O.
经口内镜甲状腺切除术前庭入路（TOETVA）的安全性和有效性将继续通过越来越多的关于该手术的文献进行验证。虽然早期病例是针对良性疾病进行的甲状腺叶切除术，但TOETVA的适应症现已扩展到包括针对特定小分化甲状腺癌（DTC）的甲状腺全切除术。该手术的肿瘤学疗效目前尚未得到证实，因为该手术仅在最近进行了描述。此外，由于通过TOETVA完成的许多病例通常是诊断性肺叶切除术，因此尚未根据美国甲状腺协会（ATA）指南确定需要或选择进一步手术干预的患者的适当管理。在此，我们介绍了一例通过TOETVA进行诊断性肺叶切除术，随后通过相同入路进行间隔完整甲状腺切除术治疗微创Hurthle细胞癌的病例。术后超声显示，患者完成甲状腺切除术后，无甲状腺残留证据，血清甲状腺球蛋白（无循环抗甲状腺抗体）为0.3 ng/mL（参考范围，1.5-38.5 ng/mL）。
The safety and efficacy of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) continues to be verified with the growing literature in regards to the procedure. While early cases were thyroid lobectomies performed for benign disease, the indications for TOETVA have now expanded to include total thyroidectomy for select small well-differentiated thyroid cancers (DTCs). Oncologic efficacy of this procedure remains unproven at this time, as the procedure was described only recently. Furthermore, as many of the cases completed via TOETVA are often diagnostic lobectomies, the appropriate management for patients requiring or opting for further surgical intervention per American Thyroid Association (ATA) guidelines has not been established. Here we present a case of a diagnostic lobectomy via TOETVA followed by interval completion thyroidectomy via the same approach for minimally invasive Hurthle cell carcinoma. Postoperative ultrasound demonstrated no evidence of thyroid remnant and serum thyroglobulin without circulating anti-thyroid antibodies was 0.3 ng/mL (reference range, 1.5-38.5 ng/mL) following the patient's completion thyroidectomy.