Near Infrared Spectroscopy in Thyroidectomy

Study Overview
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Brief Summary
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Thyroidectomy operations have traditionally been performed as open surgery. However, the scarring that occurs in the patient leads to cosmetic problems, especially in young women. Today, as a result of the development of minimally invasive surgical techniques, the number of natural orifice transluminal endoscopic surgeries (NOTES) is increasing. Surgical scars are avoided by using natural pathways such as the mouth, urethra, vagina or anus. Transoral endoscopic thyroidectomy (TOETVA) with vestibular approach, a form of NOTES, was first performed in 2011. In this method, the operation is performed through three ports entered near the gingiva-buccal sulcus. TOETVA surgeries are performed with an insufflation pressure of 6 mmHg in the neck region. No studies are examining the effects of this pressure on the blood vessels in the neck region on the blood supply to the brain tissue. Therefore, the investigators aim to compare cases operated using open thyroidectomy or TOETVA method by measuring cerebral regional tissue saturation.

Official Title
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The Effect of Vestibular Transoral Endoscopic Thyroidectomy on Cerebral Regional Oxygen Saturation: Comparison With Open Thyroidectomy

Conditions
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Thyroidectomy, Near-infrared Spectroscopy

Intervention / Treatment
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* Device: Near-infrared spectroscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA I-II Exclusion Criteria: Patients with neck surgery. Patients who received radiotherapy to the neck region. Patients with cerebrovascular or neurological disease. Patients who underwent open surgery during the operation.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| TOETVA<br>The demographic data of the patients undergoing TOETVA surgery will be recorded. Then, blood pressure, pulse pressure, pulse oximeter, end-tidal carbon dioxide, right and left cerebral regional oxygen values in the operation room will be recorded at certain intervals. It will also be recorded if complications develop. | Device: Near-infrared spectroscopy<br>* The Near-infrared spectroscopy probes will be placed in the frontal region.<br>|
| Open thyroidectomy<br>The demographic data of the patients undergoing open thyroidectomy surgery will be recorded. Then, blood pressure, pulse pressure, pulse oximeter, end-tidal carbon dioxide, right and left cerebral regional oxygen values in the operation room will be recorded at certain intervals. It will also be recorded if complications develop. | Device: Near-infrared spectroscopy<br>* The Near-infrared spectroscopy probes will be placed in the frontal region.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cerebral regional oxygen saturation in TOETVA and open thyroidectomy | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | Before induction | 
| cerebral regional oxygen saturation in TOETVA and open thyroidectomy | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | 10 minutes after induction | 
| cerebral regional oxygen saturation in TOETVA and open thyroidectomy | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | 5 minutes after operation position | 
| cerebral regional oxygen saturation in TOETVA | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | 10 minutes after insufflation | 
| cerebral regional oxygen saturation in TOETVA | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | 10 minutes after desufflation | 
| cerebral regional oxygen saturation in open thyroidectomy | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | 10 minutes after platysma incision | 
| cerebral regional oxygen saturation in open thyroidectomy | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | 10 minutes after the closing of the platysma | 
| cerebral regional oxygen saturation in TOETVA and open thyroidectomy | The values obtained from the right and left frontal region will be recorded through the near Infrared Spectroscopy probes. | Through operation completion, an average of 4 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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TOETVA, Thyroidectomy, near-infrared spectroscopy