Renovated Prediction Model for Difficult Transoral and Submental Endoscopic Thyroidectomy

Condition(s) studied

Investigational drug(s) / intervention(s)

Modified TOaST with caudal linea alba preservation: The modified procedure consists of cranial limited opening of the linea alba cervicalis with intentional preservation of the caudal linea alba-strap muscle fascial bridge. Bilateral symmetric suspension of the strap muscles is performed to maintain a centered operative window for thyroid lobectomy and, when indicated, ipsilateral central compartment lymph node dissection. If exposure is inadequate, the caudal linea alba may be further opened for safety.

Study summary

The investigators have previously proposed a prediction model for difficult transoral and submental thyroidectomy through a retrospective study. In order to better promote transoral and submental endoscopic approach for thyroid surgery and to set up an appropriate training course, the investigators aim to refine the procedure through a prospective study.

Eligibility

Primary outcome measure(s)

• Postoperative neck functional recovery at 1 month — 1 month after surgery
  Postoperative neck functional recovery will be assessed 1 month after surgery using a standardized neck function assessment, including neck discomfort, anterior neck tightness, swallowing-related traction discomfort, and neck range of motion. Higher impairment scores indicate worse neck functional recovery.
• Anterior neck tightness score — Postoperative 1 week, 1 month, and 3 months
  Anterior neck tightness will be assessed using a patient-reported visual analog scale or numerical rating scale. Higher scores indicate more severe tightness.
• Swallowing-related traction discomfort — Postoperative 1 week, 1 month, and 3 months
  Swallowing-related traction discomfort will be assessed using a patient-reported visual analog scale or numerical rating scale. Higher scores indicate more severe discomfort.

Trial sites (1)

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