{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:47:52Z","timestamp":1790246872681,"version":"4.1.0"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100009102","name":"Education Department of Jiangxi Province","doi-asserted-by":"publisher","award":["GJJ210207"],"award-info":[{"award-number":["GJJ210207"]}],"id":[{"id":"10.13039\/501100009102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>\nAbstract\n<\/jats:title><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>A new endoscopic thyroidectomy approach<jats:bold>\u2014<\/jats:bold>transoral and submental endoscopic thyroidectomy (TOaST)\u2014was applied in clinical practice and considered an improved approach for endoscopic thyroid surgery via the oral approach. This paper discusses the feasibility and effectiveness of this surgical method.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective analysis was performed on the clinical data of 54 patients who had undergone TOaST in the thyroid disease center of the First Affiliated Hospital of Nanchang University between December 2020 and December 2021. The surgical data and techniques, complications, and cosmetic outcomes of these patients were studied.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among the total 54 patients, 23 underwent unilateral subtotal thyroidectomy, 3 patients underwent bilateral subtotal thyroidectomy, 27 with unilateral thyroid cancer underwent affected thyroid\u2009+\u2009isthmus\u2009+\u2009central lymph node resection, and only 1 patient underwent total thyroidectomy. The mean operative time was 88.06\u2009\u00b1\u200912.03\u00a0min (range: 65\u2013135\u00a0min), the mean intraoperative blood loss was 8.61\u2009\u00b1\u20094.60\u00a0ml (range: 5\u201320\u00a0ml), the mean postoperative drainage volume was 49.96\u2009\u00b1\u20099.88\u00a0ml (range: 30\u201360\u00a0ml), the mean drainage time was 36.61\u2009\u00b1\u20092.65\u00a0h (range: 32\u201350\u00a0h), and the mean length of hospital stay was 46.63\u2009\u00b1\u20093.28\u00a0h (range 45\u201370\u00a0h). One patient experienced transient recurrent laryngeal nerve injury, and another patient experienced transient parathyroid dysfunction; there was no superior laryngeal nerve injury and other complications, such as postoperative subcutaneous hematoma, hypercapnia, mental nerve injury, tracheoesophageal injury, infection, or lymphatic leakage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>TOaST cannot only achieve a good therapeutic effect but also avoid mental nerve injury, reduce the discomfort of the patient\u2019s jaw, obtain a good cosmetic effect, and facilitate the operation of the operator. It is an endoscopic thyroidectomy technique with a certain clinical value.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00423-022-02663-w","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T02:02:30Z","timestamp":1661738550000},"page":"3039-3044","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical application of transoral and submental thyroidectomy (TOaST): a series of 54 human cases"],"prefix":"10.1007","volume":"407","author":[{"given":"Hang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijuan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keyi","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixian","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,29]]},"reference":[{"key":"2663_CR1","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1007\/s00464-009-0347-0","volume":"23","author":"T Benhidjeb","year":"2009","unstructured":"Benhidjeb T, Wilhelm T, Harlaar J et al (2009) Natural orifice surgery on thyroid gland: totally transoral video-assisted thyroidectomy (TOVAT): report of first experimental results of a new surgical method. 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