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Clinical Trials/NCT04842942
NCT04842942
Unknown
Phase 1

The Safety and Feasibility of Transoral Endoscopic Thyroidectomy Vestibular Approach

University Health Network, Toronto1 site in 1 country15 target enrollmentDecember 1, 2019

Overview

Phase
Phase 1
Intervention
Not specified
Conditions
Thyroid Diseases
Sponsor
University Health Network, Toronto
Enrollment
15
Locations
1
Primary Endpoint
Post-operative recurrent laryngeal nerve palsy
Last Updated
5 years ago

Overview

Brief Summary

This is a single center, prospective case series designed to assess the safety and feasibility of TOETVA in a small cohort of patients at University Health Network Toronto. Included patients will undergo a TOETVA-procedure in stead of the standard open surgical procedure.

Detailed Description

Type of Study This is a single center, prospective case series Sample Size Since this is a feasibility study we will first include 15 patients. If we find the TOETVA a safe and feasible approach, we will perform the same study in more patients using the results of this study for a power size calculation. Study Population Patients (\> 18 years) undergoing (para)thyroid surgery for the indication of a benign or indeterminate thyroid nodule, well differentiated papillary thyroid carcinoma, well-controlled Grave's disease or a parathyroid adenoma. Study Design This is a single center, prospective case series designed to assess the safety and feasibility of TOETVA in a small cohort of patients at University Health Network Toronto. Included patients will undergo a TOETVA-procedure in stead of the standard open surgical procedure. Study Intervention The study intervention in this study is the TOETVA-procedure. This is an Transoral Endoscopic Thyroidectomy Vestibular Approach. Primary Objective The study objective is to assess the safety and feasibility of this procedure in a small cohort of patients at University Health Network Toronto, Ontario. Endpoints of the study The main study endpoints consist of 1. Surgical Outcomes: rate of post-operative recurrent laryngeal nerve palsy, rate of post-operative hypocalcemia, and rate of neck incision (conversion to open), oral infections, neck infection, hematoma, seroma, subcutaneous emphysema, gas-induced embolism, surgical time, and length of stay. 2. Quality of Life - EORTC Thyroid specific Health related quality of life These endpoints will be compared to historical age/indication controls for analysis.

Registry
clinicaltrials.gov
Start Date
December 1, 2019
End Date
July 2022
Last Updated
5 years ago
Study Type
Interventional
Study Design
Single Group
Sex
All

Investigators

Responsible Party
Sponsor

Eligibility Criteria

Inclusion Criteria

  • Patients needing surgery for: Benign or indeterminate nodule less than 6 cm in size or; T1 well differentiated papillary carcinoma less than 2 cm in size or; Well-controlled Grave's disease or; Parathyroid adenoma.
  • Total thyroid size is 7-8 cm (no more than 10 cm)
  • Their age is ≥18 years and ≤80 years
  • Able to give written consent

Exclusion Criteria

  • - History of neck surgery or neck radiotherapy
  • Recurrent thyroid disease
  • Lymph node metastases
  • Presence of intraoral infections
  • Presence of extrathyroidal or substernal extensions
  • Morbid obesity
  • Contra-indication to general anesthesia with nasotracheal intubation
  • Previous mediastinal surgery
  • Any anatomical anomaly that in the opinion of the investigator may render the intervention more difficult (ex. variations in the structure of the platysmas muscle)
  • Any medical condition, which in the judgment of the investigator and/or designee makes the subject a poor candidate for the investigational procedure

Outcomes

Primary Outcomes

Post-operative recurrent laryngeal nerve palsy

Time Frame: 12 months

Number of participants with post-operative recurrent laryngeal nerve palsy

Rate of gas-induced embolism

Time Frame: 12 months

Number of participants with gas-induced embolism

Rate of subcutaneous emphysema

Time Frame: 12 months

Number of participants with subcutaneous emphysema

Surgical time

Time Frame: until surgical discharge, average of 24 hours

Surgical time in hours

Length of stay

Time Frame: until surgical discharge, average of 24 hours

Length of stay in days

Postoperative hypocalcemia

Time Frame: 12 months

Number of participants with postoperative hypocalcemia

Neck incision

Time Frame: 1 month

Number of conversions to open

Rate of oral infections

Time Frame: 12 months

Number of participants with oral infections

Rate of hematoma

Time Frame: 1 month

Number of participants with hematomas

Rate of seroma

Time Frame: 1 month

Number of participants with seromas

Rate of neck infection

Time Frame: 12 months

Number of participants with neck infections

Secondary Outcomes

  • Quality of Life Score(12 months)

Study Sites (1)

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