A Systemic Review of Transoral Thyroidectomy

Background: Transoral thyroidectomy is a kind of “natural orifice transluminal endoscopic surgery (NOTES)” which is now being performed in increasing frequency. However, the safety and feasibility have not been concluded yet. Materials and Methods: A systemic literature search was performed in Pubmed, Cochrane, and Embase databases to identify all studies written in English and published up to April 2017. The keywords used were “transoral endoscopic,” “transoral robotic,” “oral vestibular endoscopic,” and “oral vestibular robotic” combined with “thyroidectomy” or “thyroid surgery.” Results: Ten articles containing 211 cases matched the review criteria. The weighted average operative time was 119.9 minutes with an average intraoperative blood loss of 35.5 mL while the weighted average length of hospital stay was 4.0 days. The overall conversion rate to open surgery was 1.9%. An overall incidence rate of temporary hypoparathyroidism was 7.1%, temporary recurrent laryngeal nerve injury was 4.3%, whereas of mental nerve palsy was 4.3%. Conclusions: According to those reviewed literatures, we can conclude that transoral thyroidectomy is safe and feasible in well-selected patients and offers good perioperative and postoperative outcomes.