Treatments on the day of surgery were the same in both groups. All patients were required to abstain from food for at least 6 h and water for at least 2 h before surgery. All patients received intravenous cefuroxime sodium and metronidazole 30 min before anesthesia, which was repeated 6 h and 14 h after surgery. All patients were required to use a chlorhexidine gargle before surgery and continued this until 7 days postoperatively. In case of a total thyroidectomy, 600 mg calcium carbonate and 0.25 µg calcitriol would be administered orally twice a day from 2 days before surgery until the day of surgery.
Patients with benign lesions underwent unilateral or total thyroidectomy according to the size and location of the tumor. We can perform TOETVA if the tumor is no larger than 6 cm in size, while surgery is difficult if the tumor is larger than 4 cm in size. So we need to build a larger workspace to increase the mobility of the tumor, and we need to cut the specimen into long strips in the endo-bag before extracting it. On the other hand, patients diagnosed with PTC via fine needle aspiration cytology before surgery or intraoperative frozen pathological examination received unilateral or total thyroidectomy and central lymph node dissection.
The surgical technique was the same in both groups as previously described (10 (link)–12 (link)). All patients in the two groups underwent TOETVA successfully without conversion to open surgery. Venous blood was collected on the morning of the first postoperative day to measure parathyroid hormone (PTH) levels in the patients who underwent total thyroidectomy. Calcium carbonate 600 mg every 6 h and calcitriol 0.25 µg every 12 h were administered orally if serum PTH levels were lower than 15 pg/ml after surgery. Intravenous calcium supplementation was administered if the patient developed hypocalcemia-related symptoms or if serum calcium levels were lower than 1.8 mmol/L. Postoperative laryngoscopy was performed if the doctors or patients sensed abnormalities in sound. Patients in the ambulatory group were discharged from the ward within 24 h after admission, whereas those in the conventional group on the second postoperative day or later.
Patients with benign lesions underwent unilateral or total thyroidectomy according to the size and location of the tumor. We can perform TOETVA if the tumor is no larger than 6 cm in size, while surgery is difficult if the tumor is larger than 4 cm in size. So we need to build a larger workspace to increase the mobility of the tumor, and we need to cut the specimen into long strips in the endo-bag before extracting it. On the other hand, patients diagnosed with PTC via fine needle aspiration cytology before surgery or intraoperative frozen pathological examination received unilateral or total thyroidectomy and central lymph node dissection.
The surgical technique was the same in both groups as previously described (10 (link)–12 (link)). All patients in the two groups underwent TOETVA successfully without conversion to open surgery. Venous blood was collected on the morning of the first postoperative day to measure parathyroid hormone (PTH) levels in the patients who underwent total thyroidectomy. Calcium carbonate 600 mg every 6 h and calcitriol 0.25 µg every 12 h were administered orally if serum PTH levels were lower than 15 pg/ml after surgery. Intravenous calcium supplementation was administered if the patient developed hypocalcemia-related symptoms or if serum calcium levels were lower than 1.8 mmol/L. Postoperative laryngoscopy was performed if the doctors or patients sensed abnormalities in sound. Patients in the ambulatory group were discharged from the ward within 24 h after admission, whereas those in the conventional group on the second postoperative day or later.
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