Subcutaneous implantation of nodular goiter after transoral endoscopic thyroidectomy vestibular approach: A case study and review of literature.

BACKGROUND: Extrathyroid implantation or dissemination of thyroid tissue secondary to a thyroid procedure is rare. Most of these belonged to thyroid carcinoma with metastatic potential and uncommon for benign pathologies. METHODS: We report the case of a 31-year-old female who was identified to have multiple subcutaneous implantation of thyroid tissue 5 years after transoral endoscopic thyroidectomy vestibular approach. A comprehensive literature search on implantation of thyroid tissue secondary to thyroid procedures was performed. RESULTS: Accidental tearing of the capsule during previous surgery may lead to the subcutaneous implantation. Through literature review, a total 29 articles with 47 patients were identified. 33.3% were benign lesions, and implantation was mostly secondary to fine needle aspiration biopsy (46.5%). CONCLUSIONS: Subcutaneous or port site implantation after endoscopic thyroid surgery may occur in benign thyroid pathologies and therefore, oncologic principles must be strictly followed during surgery regardless of its histopathological nature.

Delayed tracheal rupture following transoral endoscopic thyroidectomy vestibular approach: Case report and review of the literature.

BACKGROUND: Although the transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been proven to be a safe procedure for select patients, as it is a novel approach, all associated complications require adequate attention. METHODS: We presented a 49-year old woman who underwent TOETVA developed delayed tracheal rupture 1 week after surgery. An extensive search of literature was carried out using PubMed, Embase, and Web of Science for studies reporting tracheal injury following endoscopic thyroidectomy. RESULTS: Thirteen cases of endoscopic thyroidectomy were analyzed, including eight cases of TOETVA. Tracheal injury occurred during various procedures, including accidental dissection, surgical needle puncture, Hegar dilation and trocar placement, and thermal injury by the energy device. CONCLUSIONS: Tracheal injury following TOETVA is an underreported complication that can be induced by various factors. Thermal injury to the trachea is more likely to cause a delayed rupture. Careful blunt dissection and standardized use of energy devices are suggested.

Intraoperative near-infrared autofluorescence imaging for hypocalcemia risk reduction after total thyroidectomy: Evidence from a meta-analysis.

This meta-analysis evaluates whether near-infrared autofluorescence (NIRAF) imaging reduces the risk of hypocalcemia after total thyroidectomy. A systematic literature search in PubMed, EMBASE, Web of Science, and Cochrane Library for studies from June 2011 to January 2021 comparing total thyroidectomy with NIRAF and conventional surgery (naked eye). Six eligible studies involving 2180 patients were included. The prevalence of transient hypocalcemia was 8.11% (40/493) and 25.19% (425/1687) in the NIRAF and naked eye groups (p < 0.0001), respectively. The prevalence of permanent hypocalcemia was 0% (0/493) and 2.19% (37/1687) in the NIRAF and naked eye groups (p = 0.05), respectively. NIRAF reduces the risk of transient hypocalcemia and may possibly lower the rate of permanent hypocalcemia. Nonetheless, further studies are needed to verify our results and evaluate the cost-effectiveness of NIRAF in real-world clinical practice.