{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:08:38Z","timestamp":1793686118528,"version":"4.5.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T00:00:00Z","timestamp":1744329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,5]]},"DOI":"10.1007\/s00464-025-11725-1","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T18:42:08Z","timestamp":1744396928000},"page":"3202-3214","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Nomogram for predicting difficult transoral and submental thyroidectomy: a retrospective model development and validation study with large-scale population"],"prefix":"10.1007","volume":"39","author":[{"given":"Ling","family":"Zhan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bomin","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixia","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianzhao","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhili","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minggao","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanbin","family":"Tao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaohui","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7024-513X","authenticated-orcid":false,"given":"Youben","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,11]]},"reference":[{"key":"11725_CR1","doi-asserted-by":"publisher","first-page":"1394","DOI":"10.1007\/s00464-021-08424-y","volume":"36","author":"J Liang","year":"2022","unstructured":"Liang J, Zhan L, Xuan M, Zhao Q, Chen L, Yan J et al (2022) Thyroidectomy for thyroid cancer via transareola single-site endoscopic approach: results of a case-match study with large-scale population. Surg Endosc 36:1394\u20131406","journal-title":"Surg Endosc"},{"key":"11725_CR2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2019.05.004","volume":"33","author":"D Zhang","year":"2019","unstructured":"Zhang D, Park D, Sun H, Anuwong A, Tufano R, Kim HY et al (2019) Indications, benefits and risks of transoral thyroidectomy. Best Pract Res Clin Endocrinol Metab 33:101280","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"11725_CR3","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1089\/lap.2018.0146","volume":"28","author":"Y Chen","year":"2018","unstructured":"Chen Y, Chomsky-Higgins K, Nwaogu I, Seib CD, Gosnell JE, Shen WT et al (2018) Hidden in plain sight: transoral and submental thyroidectomy as a compelling alternative to \u201cscarless\u201d thyroidectomy. J Laparoendosc Adv Surg Tech A 28:1374\u20131377","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"11725_CR4","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1177\/0194599818795881","volume":"159","author":"CR Razavi","year":"2018","unstructured":"Razavi CR, Vasiliou E, Tufano RP, Russell JO (2018) Learning curve for transoral endoscopic thyroid lobectomy. Otolaryngol Head Neck Surg 159:625\u2013629","journal-title":"Otolaryngol Head Neck Surg"},{"key":"11725_CR5","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1001\/jamasurg.2017.3366","volume":"153","author":"A Anuwong","year":"2018","unstructured":"Anuwong A, Ketwong K, Jitpratoom P, Sasanakietkul T, Duh QY (2018) Safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach. JAMA Surg 153:21\u201327","journal-title":"JAMA Surg"},{"key":"11725_CR6","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1186\/s12893-023-01990-z","volume":"23","author":"M Dong","year":"2023","unstructured":"Dong M, Song JL, Hu LL, Hong CC, Nie XY, Wang Z et al (2023) Analysis of preoperative influential factors and construction of a predictive nomogram of difficult thyroidectomy. BMC Surg 23:91","journal-title":"BMC Surg"},{"key":"11725_CR7","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s12893-018-0447-7","volume":"18","author":"V D'Orazi","year":"2019","unstructured":"D\u2019Orazi V, Sacconi A, Trombetta S, Karpathiotakis M, Pichelli D, Di Lorenzo E et al (2019) May predictors of difficulty in thyroid surgery increase the incidence of complications? Prospective study with the proposal of a preoperative score. BMC Surg 18:116","journal-title":"BMC Surg"},{"key":"11725_CR8","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104871","volume":"110","author":"RB Lira","year":"2020","unstructured":"Lira RB, Ramos AT, Nogueira RMR, de Carvalho GB, Russell JO, Tufano RP et al (2020) Transoral thyroidectomy (TOETVA): complications, surgical time and learning curve. Oral Oncol 110:104871","journal-title":"Oral Oncol"},{"key":"11725_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106165","volume":"96","author":"G Mathew","year":"2021","unstructured":"Mathew G, Agha R, Albrecht J, Goel P, Mukherjee I, Pai P et al (2021) STROCSS 2021: strengthening the reporting of cohort, cross-sectional and case-control studies in surgery. Int J Surg 96:106165","journal-title":"Int J Surg"},{"key":"11725_CR10","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1093\/bja\/aer024","volume":"106","author":"WH Kim","year":"2011","unstructured":"Kim WH, Ahn HJ, Lee CJ, Shin BS, Ko JS, Choi SJ et al (2011) Neck circumference to thyromental distance ratio: a new predictor of difficult intubation in obese patients. Br J Anaesth 106:743\u2013748","journal-title":"Br J Anaesth"},{"key":"11725_CR11","doi-asserted-by":"publisher","first-page":"90","DOI":"10.5152\/TJAR.2022.22077","volume":"51","author":"S Rao","year":"2023","unstructured":"Rao S, Paliwal N, Saharan S, Bihani P, Jaju R, Sharma UD et al (2023) A comparative study to evaluate difficult intubation using ratio of patient height to thyromental distance, ratio of neck circumference to thyromental distance and thyromental height in adult patients in tertiary care centre. Turk J Anaesthesiol Reanim 51:90\u201396","journal-title":"Turk J Anaesthesiol Reanim"},{"key":"11725_CR12","doi-asserted-by":"publisher","first-page":"19709","DOI":"10.1038\/s41598-021-99016-2","volume":"11","author":"JE Park","year":"2021","unstructured":"Park JE, Hwang SM, Hwang JY, Moon JH, Yang I, Woo JY et al (2021) The relationship between ultrasound findings and thyroid function in children and adolescent autoimmune diffuse thyroid diseases. Sci Rep 11:19709","journal-title":"Sci Rep"},{"key":"11725_CR13","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1210\/jcem-72-1-209","volume":"72","author":"C Marcocci","year":"1991","unstructured":"Marcocci C, Vitti P, Cetani F, Catalano F, Concetti R, Pinchera A (1991) Thyroid ultrasonography helps to identify patients with diffuse lymphocytic thyroiditis who are prone to develop hypothyroidism. J Clin Endocrinol Metab 72:209\u2013213","journal-title":"J Clin Endocrinol Metab"},{"key":"11725_CR14","doi-asserted-by":"publisher","first-page":"208","DOI":"10.2214\/AJR.09.2459","volume":"195","author":"L Anderson","year":"2010","unstructured":"Anderson L, Middleton WD, Teefey SA, Reading CC, Langer JE, Desser T et al (2010) Hashimoto thyroiditis: part 1, sonographic analysis of the nodular form of Hashimoto thyroiditis. AJR Am J Roentgenol 195:208\u2013215","journal-title":"AJR Am J Roentgenol"},{"key":"11725_CR15","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1007\/s11701-024-01869-y","volume":"18","author":"JK Lee","year":"2024","unstructured":"Lee JK, Kong Y, Choi JB, Kim W, Yu HW, Kim SJ et al (2024) TSH receptor antibody as a predictor of difficult robotic thyroidectomy in patients with Graves\u2019 disease. J Robot Surg 18:108","journal-title":"J Robot Surg"},{"key":"11725_CR16","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1007\/s13304-018-0604-7","volume":"71","author":"S Vieni","year":"2019","unstructured":"Vieni S, Graceffa G, Rizzo GEM, Latteri F, Latteri MA, Cipolla C (2019) An evaluation score of the difficulty of thyroidectomy considering operating time and preservation of recurrent laryngeal nerve. Updates Surg 71:569\u2013577","journal-title":"Updates Surg"},{"key":"11725_CR17","doi-asserted-by":"publisher","first-page":"16846","DOI":"10.1002\/cam4.6307","volume":"12","author":"L Zhan","year":"2023","unstructured":"Zhan L, Xuan M, Ding H, Liang J, Zhao Q, Chen L et al (2023) Learning curve of trans-areola single-site endoscopic thyroidectomy in a high-volume center: a CUSUM-based assessment. Cancer Med 12:16846\u201316858","journal-title":"Cancer Med"},{"key":"11725_CR18","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1089\/thy.2017.0102","volume":"27","author":"RM Tuttle","year":"2017","unstructured":"Tuttle RM, Haugen B, Perrier ND (2017) Updated American joint committee on cancer\/tumor-node-metastasis staging system for differentiated and anaplastic thyroid cancer (eighth edition): what changed and why? Thyroid 27:751\u2013756","journal-title":"Thyroid"},{"key":"11725_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","volume":"26","author":"BR Haugen","year":"2015","unstructured":"Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE et al (2015) American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 26:1\u2013133","journal-title":"Thyroid"},{"key":"11725_CR20","doi-asserted-by":"publisher","first-page":"1677","DOI":"10.1097\/JS9.0000000000000415","volume":"109","author":"G Li","year":"2023","unstructured":"Li G, Li S, Cao L, Mao W, Zhou J, Ye B et al (2023) Nomogram development and validation for predicting minimally invasive step-up approach failure in infected necrotizing pancreatitis patients: a retrospective cohort study. Int J Surg 109:1677\u20131687","journal-title":"Int J Surg"},{"key":"11725_CR21","doi-asserted-by":"publisher","first-page":"1984","DOI":"10.1007\/s00268-014-2489-z","volume":"38","author":"DF Schneider","year":"2014","unstructured":"Schneider DF, Mazeh H, Oltmann SC, Chen H, Sippel RS (2014) Novel thyroidectomy difficulty scale correlates with operative times. World J Surg 38:1984\u20131989","journal-title":"World J Surg"},{"key":"11725_CR22","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.asjsur.2015.07.008","volume":"40","author":"HY Kwak","year":"2017","unstructured":"Kwak HY, Dionigi G, Liu X, Sun H, Woo SU, Son GS et al (2017) Predictive factors for longer operative times for thyroidectomy. Asian J Surg 40:139\u2013144","journal-title":"Asian J Surg"},{"key":"11725_CR23","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.jss.2014.03.034","volume":"190","author":"VM Mok","year":"2014","unstructured":"Mok VM, Oltmann SC, Chen H, Sippel RS, Schneider DF (2014) Identifying predictors of a difficult thyroidectomy. J Surg Res 190:157\u2013163","journal-title":"J Surg Res"},{"key":"11725_CR24","doi-asserted-by":"publisher","first-page":"1943","DOI":"10.1007\/s13304-022-01371-w","volume":"74","author":"FP Prete","year":"2022","unstructured":"Prete FP, Panzera PC, Di Meo G, Pasculli A, Sgaramella LI, Calculli G et al (2022) Risk factors for difficult thyroidectomy and postoperative morbidity do not match: retrospective study from an endocrine surgery academic referral centre. Updates Surg 74:1943\u20131951","journal-title":"Updates Surg"},{"key":"11725_CR25","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1002\/bjs.10642","volume":"105","author":"L Escal","year":"2018","unstructured":"Escal L, Nougaret S, Guiu B, Bertrand MM, de Forges H, Tetreau R et al (2018) MRI-based score to predict surgical difficulty in patients with rectal cancer. Br J Surg 105:140\u2013146","journal-title":"Br J Surg"},{"key":"11725_CR26","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1097\/JS9.0000000000000352","volume":"109","author":"A Yu","year":"2023","unstructured":"Yu A, Li Y, Zhang H, Hu G, Zhao Y, Guo J et al (2023) Development and validation of a preoperative nomogram for predicting the surgical difficulty of laparoscopic colectomy for right colon cancer: a retrospective analysis. Int J Surg 109:870\u2013878","journal-title":"Int J Surg"},{"key":"11725_CR27","doi-asserted-by":"publisher","first-page":"3249","DOI":"10.1097\/JS9.0000000000001406","volume":"110","author":"Y Chen","year":"2024","unstructured":"Chen Y, Jiang J, He M, Zhong K, Tang S, Deng L et al (2024) Nomogram for predicting difficult total laparoscopic hysterectomy: a multi-institutional, retrospective model development and validation study. Int J Surg 110:3249\u20133257","journal-title":"Int J Surg"},{"key":"11725_CR28","doi-asserted-by":"publisher","first-page":"2559","DOI":"10.1038\/s41598-021-81938-6","volume":"11","author":"G Di Buono","year":"2021","unstructured":"Di Buono G, Romano G, Galia M, Amato G, Maienza E, Vernuccio F et al (2021) Difficult laparoscopic cholecystectomy and preoperative predictive factors. Sci Rep 11:2559","journal-title":"Sci Rep"},{"key":"11725_CR29","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1177\/15533506231212595","volume":"31","author":"K Anees","year":"2024","unstructured":"Anees K, Faizan M, Siddiqui SA, Anees A, Faheem K, Shoaib U (2024) Role of C-reactive protein as a predictor of difficult laparoscopic cholecystectomy. Surg Innov 31:26\u201332","journal-title":"Surg Innov"},{"key":"11725_CR30","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s00423-024-03377-x","volume":"409","author":"MD Hindawi","year":"2024","unstructured":"Hindawi MD, Ali AHG, Qafesha RM, Soliman W, Salem H, Bali E et al (2024) Transoral endoscopic thyroidectomy submental vestibular approach for early-stage papillary thyroid carcinoma: a systematic review and meta-analysis. Langenbecks Arch Surg 409:204","journal-title":"Langenbecks Arch Surg"},{"issue":"Suppl 1","key":"11725_CR31","doi-asserted-by":"publisher","first-page":"S38","DOI":"10.1016\/j.ijsu.2015.12.054","volume":"28","author":"M Milone","year":"2016","unstructured":"Milone M, Musella M, Conzo G, Campana G, De Filippo D, Coretti G et al (2016) Thyroidectomy in high body mass index patients: a single center experience. Int J Surg 28(Suppl 1):S38-41","journal-title":"Int J Surg"},{"issue":"Suppl 1","key":"11725_CR32","first-page":"E954","volume":"38","author":"HY Kwak","year":"2016","unstructured":"Kwak HY, Kim HY, Lee HY, Jung SP, Woo SU, Son GS et al (2016) Predictive factors for difficult robotic thyroidectomy using the bilateral axillo-breast approach. Head Neck 38(Suppl 1):E954-960","journal-title":"Head Neck"},{"key":"11725_CR33","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1016\/j.surg.2011.02.017","volume":"150","author":"R Buerba","year":"2011","unstructured":"Buerba R, Roman SA, Sosa JA (2011) Thyroidectomy and parathyroidectomy in patients with high body mass index are safe overall: analysis of 26,864 patients. Surgery 150:950\u2013958","journal-title":"Surgery"},{"key":"11725_CR34","first-page":"49","volume":"36","author":"MR Pellizzo","year":"2015","unstructured":"Pellizzo MR (2015) Difficult thyroidectomies. G Chir 36:49\u201356","journal-title":"G Chir"},{"key":"11725_CR35","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.jss.2012.09.017","volume":"178","author":"C McManus","year":"2012","unstructured":"McManus C, Luo J, Sippel R, Chen H (2012) Is thyroidectomy in patients with Hashimoto thyroiditis more risky? J Surg Res 178:529\u2013532","journal-title":"J Surg Res"},{"key":"11725_CR36","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.ijsu.2017.02.054","volume":"40","author":"Y Zhang","year":"2017","unstructured":"Zhang Y, Dong Z, Li J, Yang J, Yang W, Wang C (2017) Comparison of endoscopic and conventional open thyroidectomy for Graves\u2019 disease: a meta-analysis. Int J Surg 40:52\u201359","journal-title":"Int J Surg"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11725-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-11725-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11725-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T17:32:48Z","timestamp":1745947968000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-11725-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,11]]},"references-count":36,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["11725"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-11725-1","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,11]]},"assertion":[{"value":"6 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ling Zhan, Bomin Guo, Zixia Tao, Xianzhao Deng, Zheng Ding, Bo Wu, Zhili Yang, Minggao Guo, Xuanbin Tao, Xiaohui Gu and Youben Fan have no conflict of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"This study was approved by the Ethics Committees of Shanghai Sixth People\u2019s Hospital [2024-KY-236(K)].","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}