Mirghani H. Comparing trans-oral endoscopic thyroidectomy vestibular approach and trans-areolar approaches regarding postoperative infections and swallowing difficulty. World J Clin Cases 2026; 14(1): 116047 [DOI: 10.12998/wjcc.v14.i1.116047]
Corresponding Author of This Article
Hyder Mirghani, MD, Professor, Department of Internal Medicine, University of Tabuk, King Faisal Road, Educational Estate, Tabuk 71421, Saudi Arabia. s.hyder63@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 6, 2026; 14(1): 116047 Published online Jan 6, 2026. doi: 10.12998/wjcc.v14.i1.116047
Comparing trans-oral endoscopic thyroidectomy vestibular approach and trans-areolar approaches regarding postoperative infections and swallowing difficulty
Hyder Mirghani
Hyder Mirghani, Department of Internal Medicine, University of Tabuk, Tabuk 71421, Saudi Arabia
Author contributions: Mirghani HO conceived and designed the study, conducted the literature search, drafted and made critical revisions to the manuscript, and provided final approval of the version to be published.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyder Mirghani, MD, Professor, Department of Internal Medicine, University of Tabuk, King Faisal Road, Educational Estate, Tabuk 71421, Saudi Arabia. s.hyder63@hotmail.com
Received: November 2, 2025 Revised: November 25, 2025 Accepted: December 19, 2025 Published online: January 6, 2026 Processing time: 65 Days and 16.6 Hours
Abstract
BACKGROUND
Due to the increasing rate of thyroid nodules diagnosis, and the desire to avoid the unsightly cervical scar, remote thyroidectomies were invented and are increasingly performed. Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches (TAA) are the two most commonly used remote approaches. No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures.
AIM
To compared the same among patients undergoing lobectomy for unilateral thyroid carcinoma/benign thyroid nodule.
METHODS
We searched PubMed MEDLINE, Google Scholar, and Cochrane Library from the date of the first published article up to August 2025. The term used were transoral thyroidectomy vestibular approach, trans areolar thyroidectomy, scarless thyroidectomy, remote thyroidectomy, infections, postoperative, inflammation, dysphagia, and swallowing difficulties. We identified 130 studies, of them, 30 full texts were screened and only six studies were included in the final meta-analysis.
RESULTS
Postoperative infections were not different between the two approaches, odd ratio = 1.33, 95% confidence interval: 0.50-3.53, the χ2 was 1.92 and the P-value for overall effect of 0.57. Similarly, transient swallowing difficulty was not different between the two forms of surgery, with odd ratio = 0.91, 95% confidence interval: 0.35-2.40; the χ2 was 1.32, and the P-value for overall effect of 0.85.
CONCLUSION
No significant statistical differences were evident between trans-oral endoscopic thyroidectomy vestibular approach and trans-areolar approach regarding postoperative infection and transient swallowing difficulties. Further longer randomized trials are needed.
Core Tip: Due to the increasing rate of thyroid nodules diagnosis, and the desire to avoid the unsightly cervical scar, remote thyroidectomies were invented and are increasingly performed. Transoral endoscopic thyroidectomy vestibular approach and trans-areolar approaches are the two most commonly used remote approaches. No previous meta-analysis has compared postoperative infections and swallowing difficulties among the two procedures. Therefore, we reviewed the literature on this important topic to the better choice of scarless surgery procedure.
