Clinical Report: Assessment of TOETVA for Papillary Thyroid Carcinoma

Overview

This network meta-analysis evaluates the safety and effectiveness of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) compared to open thyroidectomy (OT) and axillary breast approach (ABA) for treating papillary thyroid carcinoma (PTC).

Background

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, accounting for over 80% of cases. Surgical resection remains the primary treatment, but traditional open thyroidectomy can leave visible scars, impacting patient satisfaction. The emergence of minimally invasive techniques, such as TOETVA, aims to improve cosmetic outcomes while maintaining surgical efficacy.

Data Highlights

Key Findings

• TOETVA had longer operative times compared to OT and ABA.
• OT resulted in shorter postoperative hospital stays and lower drainage volumes compared to TOETVA.
• No significant differences in tumor radicality or recurrence rates among the three approaches.
• OT provided better sensory nerve protection compared to TOETVA.
• TOETVA was associated with a lower risk of temporary hypoparathyroidism compared to OT.
• No significant differences in complications such as bleeding or infection among the three techniques.

Clinical Implications

Clinicians should consider the specific advantages and disadvantages of each approach when discussing surgical options with patients.

Conclusion

TOETVA, OT, and ABA are all effective surgical options for PTC.

Related Resources & Content

1. Frontiers, Source, 2026 -- Efficacy and safety of transoral endoscopic thyroidectomy vestibular approach of papillary thyroid carcinoma: a network meta-analysis
2. 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer - Matthew D. Ringel et al., 2025
3. Remote-Access Thyroidectomy and Parathyroidectomy: A 2025 Consensus Statement from the Asia-Pacific Society of Thyroid Surgery et al., 2025
4. Submental Vestibular Approach for Transoral Endoscopic Thyroidectomy in Early-Stage Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis
5. Transoral Endoscopic Thyroidectomy: Preliminary Findings from the European TOETVA Research Group
6. Updates in Surgery — Assessing the Risk of Surgical Site Infections in Transoral Thyroid Surgery via the Vestibular Approach
7. An Overview of Intermittent Intraoperative Neural Monitoring for Mitigating Recurrent Laryngeal Nerve Damage in Thyroid Surgery: A Systematic Review Following PRISMA Guidelines of Existing Meta-Analyses
8. Submental Vestibular Approach for Transoral Endoscopic Thyroidectomy in Early-Stage Papillary Thyroid Carcinoma: A Systematic Review and Meta-Analysis
9. Transoral Endoscopic Thyroidectomy: Preliminary Findings from the European TOETVA Research Group
10. Assessing the Risk of Surgical Site Infections in Transoral Thyroid Surgery via the Vestibular Approach
11. 2025 American Thyroid Association Management Guidelines for Adult Patients with Differentiated Thyroid Cancer - Matthew D. Ringel, Julie Ann Sosa, Zubair Baloch, Lindsay Bischoff, Gary Bloom, Gregory A. Brent, Pamela L. Brock, Roger Chou, Robert R. Flavell, Whitney Goldner, Elizabeth G. Grubbs, Megan Haymart, Steven M. Larson, Angela M. Leung, Joseph R. Osborne, John A. Ridge, Bruce Robinson, David L. Steward, Ralph P. Tufano, Lori J. Wirth, 2025
12. Remote-Access Thyroidectomy and Parathyroidectomy: A 2025 Consensus Statement from the Asia-Pacific Society of Thyroid Surgery, American Head and Neck Society, American Association of Endocrine Surgeons, American Thyroid Association, European Society of Endocrine Surgeons, and Latin American Thyroid Society - Jonathon O. Russell, Kyung Tae, Mara Y. Roth, Runhua Hou, Insoo Suh, Ralph P. Tufano, Victoria Banucchi, Emad Kandil, Raymon H. Grogan, Eren Berber, Angkoon Anuwong, Woong Youn Chung, Hoon Yub Kim, Tsung-Lin Yang, Kyu Eun Lee, Yoon Woo Koh, Marco Raffaelli, Özer Makay, Marcin Barczynski, Renan B. Lira, Alvaro Sanabria, Luiz P. Kowalski, 2025
13. Frontiers | Efficacy and safety of transoral endoscopic thyroidectomy vestibular approach of papillary thyroid carcinoma: a network meta-analysis