SYSTEMATIC REVIEW article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1606389
Outcomes of transoral endoscopic thyroidectomy vestibular approach versus endoscopic thyroidectomy via areola approach in the treatment of thyroid carcinoma: a meta-analysis
Provisionally accepted
- Guangxi University of Science and Technology, Liuzhou, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction This meta-analysis was designed to compare the outcomes of transoral endoscopic thyroidectomy vestibular approach (TOETVA) versus endoscopic thyroidectomy via areola approach (ETAA) for thyroid carcinoma.Five databases (PubMed, Embase, Web of Science, Cochrane Library, and Scopus) were systematically searched for studies comparing endoscopic thyroidectomy via TOETVA versus ETAA in patients with thyroid carcinoma. The search was conducted from the databases establishment to May 31, 2025. Operative time, intraoperative blood loss, number of central lymph node dissections, postoperative drainage volume, length of hospital stay, postoperative infection, hypoparathyroidism, perioperative recurrent laryngeal nerve injury, complication, hypocalcemia, subcutaneous ecchymosis, cough, trachyphonia, postoperative PTH, postoperative blood calcium, pain score of VAS, swallowing discomfort, hematoma, central lymph node dissection time, and satisfaction with cosmetic effects were subjected to meta-analyses.Totally 15 studies were included in the meta-analysis. The meta-analysis included a group of 1961 patients diagnosed with thyroid carcinoma. Within this cohort, 777 patients received endoscopic thyroidectomy via TOETVA, while 1184 patients received endoscopic thyroidectomy via ETAA. Compared with ETAA, TOETVA yielded fewer intraoperative bleeding volume (WMD = -1 mL, 95% CI: -3 to 0, P = 0.03), more number of central lymph node dissection (WMD = 1.4, 95% CI: 0.3 to 2.3, P = 0.02), and higher satisfaction with cosmetic effects of the patients (WMD = 0.93, 95% CI: 0.42 to 1.43, P = 0.0004), but longer operative time (WMD = 17 min, 95% CI: 8 to 26, P = 0.0002). There was no statistically significant difference between the two groups regarding postoperative drainage volume, postoperative infection, perioperative recurrent laryngeal nerve injury, hypocalcemia, swallowing discomfort, hypoparathyroidism, and hospitalization time.The findings indicated that both the TOETVA and ETAA approaches demonstrated safe and reliable clinical efficacy. The TOETVA approach offered additional benefits concerning satisfaction with cosmetic effects and central lymph node dissection.TOETVA is an optimal option for patients seeking scarless surgical procedures.
Keywords: Thyroid carcinoma, endoscopic, Thyroidectomy, Transoral endoscopic thyroidectomy vestibular approach, endoscopic thyroidectomy via areola approach, Cosmetic, Satisfaction, Meta-analysis
Received: 05 Apr 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Wu, Liang, Wang, Liang, Yin, Yang, Quan and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zongyong Li, Guangxi University of Science and Technology, Liuzhou, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.