Evidence map›Paper›PMID 29039144›Full record

ArticleEndocrine2018

Transoral endoscopic thyroidectomy via a vestibular approach: why and how?

Gianlorenzo Dionigi, Young Jun Chai, Ralph P Tufano, Angkoon Anuwong, Hoon Yub Kim

Abstract read
PubMed Publisher
In one paragraph

Article in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  14. Transoral thyroid and parathyroid surgery in Brazil: where are we?Revista do Colegio Brasileiro de Cirurgioes · 2023
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  19. Natural Orifice Endoscopic Thyroidectomy via Transoral Vestibular Approach (TOVA): Single Surgeon Experience from North India.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Gianlorenzo DionigiDivision for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital G. Martino, University of Messina, Via C. Valeria 1, 98125, Messina, Italy.ORCID 0000-0003-0864-6087
Young Jun ChaiDepartment of Surgery, Seoul Metropolitan Government, Seoul National University Boramae Medical Center, Dongjak-gu, Seoul, South Korea.ORCID 0000-0001-8830-3433
Ralph P TufanoDivision of Head and Neck Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID 0000-0002-2219-3208
Angkoon AnuwongMinimally Invasive and Endocrine Division, Department of Surgery, Police General Hospital, Bangkok, Thailand.
Hoon Yub KimDepartment of Surgery, Korea University College of Medicine, Seoul, Korea, Anam Hospital, Seoul, Korea. hoonyubkim@gmail.com.ORCID 0000-0002-6731-3912

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel, scar-free surgical procedure that does not require visible incisions. Indications for TOETVA are as follows: predicted gland width on diagnostic imaging ≤10 cm; a thyroid volume outline of <45 mL or dominant nodule dimension of ≤50 mm; three or four Bethesda lesions; a primary papillary microcarcinoma without local or distant metastasis; and patient request for optimal esthetic results. Contraindications are as follows: patients unfit for general anesthesia; precedent radiation in the head, neck, upper mediastinum; antecedent neck surgery; recurrent goiter; a gland volume of >45 mL or main nodule diameter of >50 mm; and documentation of lymph node or distant metastases, tracheal/esophageal infiltration, preoperative laryngeal nerve palsy, hyperthyroidism, mediastinal goiter, or an oral abscess. Patients with poorly differentiated or un-differentiated cancer, dorsal extrathyroidal radius, and/or lateral neck metastasis are not suitable for TOETVA. Following the introduction of a robotic surgical system, enabling a three-dimensional surgical view and the use of articulating instruments, TOETVA became suitable for most differentiated thyroid cancers without evidence of extensive extrathyroidal invasion or lateral neck metastasis. The procedure is performed using a vestibular approach and three-port technique; a 10-mm port is used for the 30° endoscope, two 5-mm ports are used for the dissecting and coagulating instruments, and an 8-mm port is placed in the axillary fold during the robotic procedure to enhance fine countertraction of tissue for radical oncological dissection. TOETVA follows surgical planes and is probably the best scar-free approach to the thyroid, given the short distance between the gland and intraoral incisions.

Indexed as

HumansNatural Orifice Endoscopic SurgeryThyroidectomyThyroid GlandThyroid NeoplasmsEndoscopic thyroidectomyNatural orifice transluminal endoscopic surgeryRobotic thyroidectomyTransoral thyroidectomy

Identifiers

PMID29039144

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.