Trans Oral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) in Brazil: Safety and complications during learning curve.

Autor:	Bertelli AAT; Disciplina de Cirurgia de Cabeça e Pescoço, Departamento de Cirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil., Rangel LG; Universidade do Estado do Rio de Janeiro, RJ, Brasil., Lira RB; A.C. Camargo Cancer Center, São Paulo, SP, Brasil., Tesseroli MAS; Unimed Chapecó Hospital, Chapecó, SC, Brasil., Santos IC; Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brasil., Silva GD; Serviço de Cirurgia de Cabeça e Pescoço, Hospital Central da Polícia Militar do Rio de Janeiro, Universidade do Estado do Rio de Janeiro, RJ, Brasil., Gomes MA; Hospital Federal de Bonsucesso e Universidade do Estado do Rio de Janeiro, RJ, Brasil., Tenório LR; Disciplina de Cirurgia de Cabeça e Pescoço, Departamento de Cirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil, tenoriolr@gmail.com., Kowalski LP; A.C. Camargo Cancer Center, São Paulo, SP, Brasil., Gonçalves AJ; Disciplina de Cirurgia de Cabeça e Pescoço, Departamento de Cirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil., Russel JO; Head and Neck Endocrine Surgery, Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, USA., Tufano RP; Head and Neck Endocrine Surgery, Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, USA.
Jazyk:	angličtina
Zdroj:	Archives of endocrinology and metabolism [Arch Endocrinol Metab] 2021 Jun 29; Vol. 65 (3), pp. 259-264.
DOI:	10.20945/2359-3997000000380
Abstrakt:	Objective: The aim of this study was to address the first cases of TOETVA done in Brazil, by TOETVA-Bra study group, regarding safety and complications. Methods: Series of the first 93 TOETVAs cases in Brazil. All authors except LPK, AJG JOR and RPT received TOETVA training including cadaveric hands-on in Thailand or United States (Johns Hopkins Medicine) during 2017. After they came back to Brazil and started doing their first TOETVA cases in the cities of Rio de Janeiro, Sao Paulo and Chapecó they agreed to collaborate and gather data using an online spreadsheet. All patients were submitted to the technique described by Anuwong. Results: A total of 93 patients underwent TOETVA. Most patients (58.1%) were submitted to total thyroidectomy and 59.1% had benign disease. Two patients (2.2%) needed conversion to open surgery. Five patients (9.3%) developed transient hypoparathyroidism and there were 3 (2.0%) temporary recurrent laryngeal nerve palsy. There was one (0.7%) permanent unilateral palsy. Twenty patients had some sort of complication, 16.1% were minor and 5.4% were major. A total of 73 patients (78.5%) had an uneventful recovery. Conclusion: The technique is reproducible with a low complication rate. While further studies are needed to confirm equivalency, early efforts suggest that TOETVA is not inferior to traditional open thyroidectomy in appropriately selected patients.
Databáze:	MEDLINE
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