{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T11:18:11Z","timestamp":1794482291127,"version":"4.9.1"},"reference-count":84,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Remote-access thyroid and parathyroid surgery has emerged as a safe and effective alternative to conventional transcervical approaches, particularly valued for its superior cosmetic outcomes. However, global adoption remains inconsistent, hindered by variability in clinical indications, geographic and economic factors, learning curves, and training infrastructure. This international consensus statement aims to provide comprehensive, evidence-based guidance on patient selection, surgeon training, surgical approaches, and expected outcomes. An expert panel was convened with representatives nominated by six leading international societies The Asia-Pacific Society of Thyroid Surgery, American Head and Neck Society, American Association of Endocrine Surgeons, American Thyroid Association, European Society of Endocrine Surgeons, and Latin American Thyroid Society. A modified Delphi process, consistent with Conducting and Reporting of Delphi Studies guidelines, was used. Expert subgroups performed targeted literature reviews and formulated recommendations, which were refined through multiple rounds of anonymous electronic voting. Consensus was defined\n                      <jats:italic toggle=\"yes\">a priori<\/jats:italic>\n                      as \u226580% agreement on a 5-point Likert scale.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary:<\/jats:title>\n                    <jats:p>A total of 23 consensus statements were established. These include recommendations on minimum surgeon volume requirements, structured training pathways (including cadaveric dissection and proctoring), and patient eligibility based on disease characteristics. The four most commonly utilized remote-access approaches\u2014transoral, gasless transaxillary, bilateral axillo-breast, and retroauricular\u2014each offer distinct advantages and limitations. With an experienced surgeon, these techniques demonstrate oncologic and surgical outcomes comparable with open surgery, with notable improvements in cosmetic satisfaction. Approach-specific complications and extended operative times were acknowledged. The importance of informed consent and the development of high-volume centers of excellence was emphasized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This international consensus statement provides structured, evidence-informed recommendations to support the safe and effective implementation of remote-access thyroid and parathyroid surgery. Widespread dissemination and adoption of these recommendations may improve patient outcomes and promote global standardization of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256251388410","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T08:46:50Z","timestamp":1761554810000},"page":"1285-1296","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Remote-Access Thyroidectomy and Parathyroidectomy: A 2025 Consensus Statement from the Asia-Pacific Society of Thyroid Surgery, American Head and Neck Society, American Association of Endocrine Surgeons, American Thyroid Association, European Society of Endocrine Surgeons, and Latin American Thyroid Society"],"prefix":"10.1177","volume":"35","author":[{"given":"Jonathon O.","family":"Russell","sequence":"first","affiliation":[{"name":"The Russell Center for Endocrine Health, Columbia, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung","family":"Tae","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara Y.","family":"Roth","sequence":"additional","affiliation":[{"name":"Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runhua","family":"Hou","sequence":"additional","affiliation":[{"name":"The Thyroid Associates, Division of Endocrinology, Massachusetts General Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Insoo","family":"Suh","sequence":"additional","affiliation":[{"name":"Division of Endocrine Surgery, Department of Surgery, NYU Langone Health, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph P.","family":"Tufano","sequence":"additional","affiliation":[{"name":"SMH\/FPG Thyroid and Parathyroid Center, Sarasota, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Banucchi","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Kandil","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymon H.","family":"Grogan","sequence":"additional","affiliation":[{"name":"Endocrine Surgery, Baylor College of Medicine, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eren","family":"Berber","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angkoon","family":"Anuwong","sequence":"additional","affiliation":[{"name":"Minimally Invasive and Endocrine Surgery Division, Department of Surgery, Police General Hospital, Bangkok, Thailand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woong Youn","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoon Yub","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Korea University College of Medicine, Korea University Hospital, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Lin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyu Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon Woo","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Raffaelli","sequence":"additional","affiliation":[{"name":"Division of Endocrine and Metabolic Surgery, Fondazione Policlinico Universitario 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