Comparative effectiveness totally endoscopic thyroidectomy via completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation.

Objective: This study aims to evaluate the therapeutic effectiveness of totally endoscopic thyroidectomy via the completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation.

Methods: A total of 60 patients with thyroid tumors who were admitted to Panyu College Affiliated Hospital from August 2022 to August 2023 were collected in this study. The patients were divided into two groups, the transoral endoscopic thyroidectomy group (20 cases) and the totally endoscopic thyroidectomy via the completely submental tri-hole approach group (40 cases). Then, we evaluated the difference of surgical data, operative details, postoperative complications, duration of postoperative swelling, cosmetic satisfaction, discomfort during eating, and pain scores between two groups.

Results: There were no significant differences between two groups in terms of operation time, intraoperative blood loss, postoperative drainage, extubation time, length of hospital stay, autotransplantation of parathyroid glands, or postoperative swelling. And neither group experienced voice hoarseness, postoperative bleeding, or lymphatic leakage. The incidence of hypocalcemia did not differ significantly between two groups, although the transoral endoscopic thyroidectomy group had a significantly higher incidence of chin numbness (p<0.01). Futhermore, there was no obvious differences in neck pain scores or cosmetic satisfaction scores at 3 days, 7 days, 2 weeks, and 1 month postoperatively. However, the discomfort during eating score was markedly lower in the totally endoscopic thyroidectomy group compared to the transoral endoscopic thyroidectomy group (P < 0.05).

Conclusion: Totally endoscopic thyroidectomy via the completely submental tri-hole approach offers advantages in reducing postoperative discomfort during eating compared to transoral endoscopic thyroidectomy, indicating promising prospects for clinical application.