Evidence map›Paper›PMID 34748089›Full record

ArticleSurgical endoscopy2022

Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) learning curve: a regression analysis of complication rates and severity.

Gustavo Fernandez-Ranvier, Benjamin Lieberman, Daniela Guevara, Ana Voogd, Maria Eugenia Matsuda, Kaitlyn Eck, William B Inabnet, Gabriel Antonio Damiano

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Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–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

9 citing papers in PubMed.

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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

8 authors.

Gustavo Fernandez-RanvierDivision of Metabolic, Endocrine and Minimally Invasive Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, 5 East 98th Street, New York, NY, 10029, USA. gustavo.fernandez-ranvier@mountsinai.org.ORCID http://orcid.org/0000-0002-1467-5098
Benjamin LiebermanDepartment of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA.
Daniela GuevaraDepartment of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, NY, USA.
Ana VoogdDepartment of Head and Neck Surgery, Hospital Universitario Austral, Pilar, Argentina.
Maria Eugenia MatsudaDepartment of Head and Neck Surgery, Hospital Universitario Austral, Pilar, Argentina.
Kaitlyn EckState University of New York College at Geneseo, Geneseo, NY, USA.
William B InabnetDepartment of Surgery, University of Kentucky College of Medicine, Lexington, KY, USA.
Gabriel Antonio DamianoDivision of Head and Neck Surgery, Department of Surgery, Hospital Ignacio Pirovano, Buenos Aires, Argentina.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) is a natural orifice transluminal endoscopic surgery that offers a truly scarless approach to thyroidectomy. Introduced in 2008, there is a growing body of literature establishing it as a safe endoscopic approach for thyroid procedures. While it is not yet widely practiced, it is quickly growing in popularity. As more surgeons begin to add this technique to their repertoire the question of the learning curve has to be examined.

methodsCase series from the initial TOETVA operations of four surgeons at three different hospitals were examined. Binomial and ordinal logistic regression were used to characterize the changes in complication rate and severity as they related to case number in the series. Statistics were performed in Minitab and SAS.

resultsEach surgeon performed between 23 and 40 TOETVA operations for a total of 130 cases. Binary logistic regression shows a negative relationship between case number and complication rate (P < 0.001, Odds Ratio: 0.91). Ordinal logistic regression shows a negative relationship between case number and complication severity (P < 0.001, Odds Ratio: 1.07). The maximum slope of improvement of complication rate occurred at case number 12.

conclusionThe most significant decrease in complications for TOETVA occurs at case 12. As case number progresses, there is a significant decrease in both the risk of a complication occurring and of the severity of that complication. These results support the previously published data on TOETVA learning curve based on operative time.

Indexed as

Natural Orifice Endoscopic SurgeryThyroidectomyHumansLearning CurveRegression AnalysisThyroid GlandLearning curveNatural orifice transluminal endoscopic surgeryTOETVATransoral thyroidectomy

Identifiers

PMID34748089

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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.