Objective To construct and validate the application effect of a standardized nursing protocol for transoral endoscopic thyroidectomy via vestibular approach (TOETVA) led by nurses in operating room under guidance of enhanced recovery after surgery (ERAS).

Methods Based on Delphi method, a TOETVA protocol led by operating room nurses under ERAS guidance was constructed. Eighty patients were randomly divided into control group and experimental group using random number table method, with 40 cases in each group. The control group received routine nursing interventions, while the experimental group received the standardized TOETVA nursing protocol led by operating room nurses under ERAS guidance. The number of days of drainage tube indwelling, length of hospital stay, incidence of complications, anxiety levels, and nursing satisfaction were compared between the two groups.

Results Compared with the control group, the experimental group had a shorter number of days of drainage tube indwelling and length of hospital stay, as well as higher nursing satisfaction (P < 0.05). There was no statistically significant difference in anxiety levels between the two groups before intervention (P>0.05). After intervention, the score of the Self-Rating Anxiety Scale (SAS) in the experimental group decreased and was lower than that in the control group (P < 0.05). However, there was no statistically significant difference in the incidence of complications between the two groups (P>0.05).

Conclusion The construction of a standardized TOETVA nursing protocol led by nurses in operating room under ERAS guidance is scientific and effective. It has positive significance in shortening the drainage tube indwelling time and hospital stay, improving patients' anxiety, and enhancing patients′ nursing satisfaction.