Outcomes of Per-oral Endoscopic Thyroidectomy (POET): A New Trend for Scarfree Thyroidectomy

Abstract

Yip Swee Yan and Yip Kok Thye

Objectives: This paper discusses the surgical outcomes of POET compared to open thyroidectomy (OT) and other approaches of video thyroidectomy (VT) such as chest or axillary approach to investigate the feasibility of POET as a safe alternative. Background: Per-Oral Endoscopic Thyroidectomy (POET) is a developing novel technique based on the principles of minimally invasive surgery offering “scar-free” thyroidectomy. To date, results from various individual centers have been published internationally but none from UK, Malaysia or Singapore.

Methods: This is a single tertiary hospital, single surgeon based retrospective analysis of 98 selected patients (mean age: 43.5 years old) undergoing POET in 12 months (July 2017 to July 2018). It records the complication rates post-operatively until day of discharge.

Results: The average length of stay is 2 days and average time of operation is 69 minutes. There was no blood loss >100ml and no wound infection recorded among the 98 patients. Only 1 out of 98 patients (1%) had permanent recurrent laryngeal nerve (RLN) palsy. Clinical hypocalcemia described as cramp and lip paresthesia was experienced by 6 patients (6%). 5% had transient mental nerve injury described as mental paresthesia.

Conclusion: POET is a promising safe alternative technique to thyroidectomy with comparable surgical outcome yet significantly better cosmetic outcome. This technique has a strong potential to be useful when lowering the rate of developing keloidal scar and hypertrophic scaring. POET can be an option to offer patients who are especially driven to achieve perfect cosmesis.

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