24. Kết quả sớm phẫu thuật nội soi đường miệng điều trị ung thư tuyến giáp thể nhú cT1aN0M0 tại Bệnh viện Đại học Y Hà Nội

Abstract

The purpose of this study was to evaluate the early surgical outcomes of transoral endoscopic thyroidectomy vestibular approach (TOETVA) for cT1aN0M0 papillary thyroid carcinoma performed by the Department of Oncology and Palliative Care at Hanoi Medical University Hospital. A cross- sectional study was performed on 830 patients diagnosed for cT1aN0M0 papilary thyroid carcinoma; thyroidectomy was completed by TOETVA from 01/2019 to 08/2023. Patients‘ mean age was 32.3 ± 8.5 (13 - 67) years old. 800 patients (96.4%) were female. Lobectomy and isthmusectomy and ipsilateral central lymph node dissection was performed for 732 cases (88.2%); total thyroidectomy and central lymph node dissection was applied for 88 cases (10.6%); lobectomy and isthmusectomy and excision of tumor and ipsilateral central lymph node dissection was performed for 10 cases (1.2%); The average number of harvested lymph nodes was 5.3 ± 3.8 (0 - 24) lymph nodes. The rate of occult lymph node micro metastases was 32.6%. The average of tumor size and the number of the lymph node metastasis group was 6.3 ± 1.8 and 6.6 ± 1.7, respectively. The cut-off value of the tumor size for predicting central lymph node micrometastasis was 5.85mm (sensitivity = 0.713, specificity = 0.444, p = 0.008). Transient vocal cord palsy was recorded in 105 cases (12.6%); transient hypoparathyroidism was noted in 22 case (2.7%); numb chin was identified in 162 patients (19.5%). Tracheal perforation during surgery was noted in 2 cases (0.24%). There were no case of permanent hypoparathyroidism, permanent vocal cord palsy and numb chin. Post-operative infection occurred in 2 cases (0.24%). The treatment of cT1aN0M0 papillary thyroid carcinoma by TOETVA are important, safe and highly effective.