Transoral endoscopic thyroidectomy using the vestibular approach in pediatric patients: 5-year experience in a single center in Vietnam.

[OBJECTIVE] To evaluate the clinical and oncological outcomes of transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) in the management of pediatric patients with benign and malignant thyroid lesions in Vietnam.

[METHODS] A cross-sectional study was performed on pediatric patients (≤18 years old) who underwent TOETVA for thyroid cancer and benign thyroid nodules between August 2019 to September 2024.

[RESULTS] Of the 28 patients included in the study, 23 were female (82.1%), and 5 were male (17.9%) with a mean age of 15.86±2.45 years. Mean tumor size on ultrasound was 19.47±13.63 mm. TOETVA was completed successfully in all cases. Postoperative histopathological findings revealed benign lesions in 13 patients, differentiated thyroid carcinoma in 14 patients and non-invasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) in one patient; central neck dissection (CND) was performed in 15 patients; nine of them had occult lymph node metastasis. Postoperative complications included transient hypoparathyroidism (3.6%) and vocal cord palsy (7.1%), all of which resolved. No permanent complications or recurrences were observed over a median follow-up of 26.5 months.

[CONCLUSIONS] TOETVA appears feasible for the treatment of thyroid nodules in children. However, larger prospective studies are needed to confirm these findings.