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Article: A systematic review and meta-analysis comparing outcomes between robotic-assisted thyroidectomy and non-robotic endoscopic thyroidectomy
Title | A systematic review and meta-analysis comparing outcomes between robotic-assisted thyroidectomy and non-robotic endoscopic thyroidectomy |
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Authors | |
Keywords | Total thyroidectomy Robotic thyroidectomy Recurrent laryngeal nerve Papillary thyroid carcinoma Non-robotic thyroidectomy Nerve monitoring Hypoparathyroidism Endoscopic thyroidectomy Central neck dissection |
Issue Date | 2014 |
Publisher | Elsevier Inc.. The Journal's web site is located at http://www.elsevier.com/locate/jsre |
Citation | Journal of Surgical Research, 2014, v. 191 n. 2, p. 389-398 How to Cite? |
Abstract | Background: Despite its feasibility, using the da Vinci robot in remote-access thyroidectomy remains controversial. This meta-analysis compared surgical and oncological outcomes between robotic-assisted thyroidectomy (RT) and non-robotic endoscopic thyroidectomy (ET). Methods: A systematic review was performed to identify studies comparing outcomes between RT and ET. Outcomes included operating time, drain output, complications, number of central lymph nodes retrieved, and preablation stimulated thyroglobulin level. A random-effects model was used. Results: Six studies were eligible. Of the 3510 patients, 2167 (61.7%) underwent RT whereas 1343 (38.3%) underwent ET. Despite a higher drain output (185.8 mLs versus 173.3 mLs, P = 0.019), RT had fewer temporary recurrent laryngeal nerve injury (2.6% versus 3.3%, P = 0.035) and shorter length of hospital stay (3.4 d versus 3.5 d, P = 0.030). In terms of oncological outcomes, despite higher incidence of multicentricity and larger tumors, the number of central lymph nodes retrieved during unilateral central neck dissection in RT was significantly greater than ET (4.5 ± 2.6 and 3.4 ± 2.5, P < 0.001) whereas the preablation stimulated thyroglobulin was comparable (0.8 ng/mL versus 1.1 ng/mL, P = 0.456). However, follow-up data were relatively scarce. Conclusions: Adding the robot in remote-access thyroidectomy was associated with a significantly lower risk of temporary recurrent laryngeal nerve injury and shorter length of hospital stay. However, despite achieving a comparable level of surgical completeness for low-risk differentiated thyroid carcinoma between RT and ET, this study highlighted the limitations with the current literature and the need for more prospective studies with adequate follow-up. © 2014 Elsevier Inc. All rights reserved. |
Persistent Identifier | http://hdl.handle.net/10722/202218 |
ISSN | 2023 Impact Factor: 1.8 2023 SCImago Journal Rankings: 0.748 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lang, BHH | - |
dc.contributor.author | Wong, CKH | - |
dc.contributor.author | Tsang, JS | - |
dc.contributor.author | Wong, KP | - |
dc.date.accessioned | 2014-08-22T02:57:49Z | - |
dc.date.available | 2014-08-22T02:57:49Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Journal of Surgical Research, 2014, v. 191 n. 2, p. 389-398 | - |
dc.identifier.issn | 0022-4804 | - |
dc.identifier.uri | http://hdl.handle.net/10722/202218 | - |
dc.description.abstract | Background: Despite its feasibility, using the da Vinci robot in remote-access thyroidectomy remains controversial. This meta-analysis compared surgical and oncological outcomes between robotic-assisted thyroidectomy (RT) and non-robotic endoscopic thyroidectomy (ET). Methods: A systematic review was performed to identify studies comparing outcomes between RT and ET. Outcomes included operating time, drain output, complications, number of central lymph nodes retrieved, and preablation stimulated thyroglobulin level. A random-effects model was used. Results: Six studies were eligible. Of the 3510 patients, 2167 (61.7%) underwent RT whereas 1343 (38.3%) underwent ET. Despite a higher drain output (185.8 mLs versus 173.3 mLs, P = 0.019), RT had fewer temporary recurrent laryngeal nerve injury (2.6% versus 3.3%, P = 0.035) and shorter length of hospital stay (3.4 d versus 3.5 d, P = 0.030). In terms of oncological outcomes, despite higher incidence of multicentricity and larger tumors, the number of central lymph nodes retrieved during unilateral central neck dissection in RT was significantly greater than ET (4.5 ± 2.6 and 3.4 ± 2.5, P < 0.001) whereas the preablation stimulated thyroglobulin was comparable (0.8 ng/mL versus 1.1 ng/mL, P = 0.456). However, follow-up data were relatively scarce. Conclusions: Adding the robot in remote-access thyroidectomy was associated with a significantly lower risk of temporary recurrent laryngeal nerve injury and shorter length of hospital stay. However, despite achieving a comparable level of surgical completeness for low-risk differentiated thyroid carcinoma between RT and ET, this study highlighted the limitations with the current literature and the need for more prospective studies with adequate follow-up. © 2014 Elsevier Inc. All rights reserved. | - |
dc.language | eng | - |
dc.publisher | Elsevier Inc.. The Journal's web site is located at http://www.elsevier.com/locate/jsre | - |
dc.relation.ispartof | Journal of Surgical Research | - |
dc.rights | NOTICE: this is the author’s version of a work that was accepted for publication in Journal of Surgical Research. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Surgical Research, 2014, v. 191 n. 2, p. 389-398. DOI 10.1016/j.jss.2014.04.023 | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Total thyroidectomy | - |
dc.subject | Robotic thyroidectomy | - |
dc.subject | Recurrent laryngeal nerve | - |
dc.subject | Papillary thyroid carcinoma | - |
dc.subject | Non-robotic thyroidectomy | - |
dc.subject | Nerve monitoring | - |
dc.subject | Hypoparathyroidism | - |
dc.subject | Endoscopic thyroidectomy | - |
dc.subject | Central neck dissection | - |
dc.title | A systematic review and meta-analysis comparing outcomes between robotic-assisted thyroidectomy and non-robotic endoscopic thyroidectomy | - |
dc.type | Article | - |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1016/j.jss.2014.04.023 | - |
dc.identifier.pmid | 24814766 | - |
dc.identifier.scopus | eid_2-s2.0-84908256622 | - |
dc.identifier.hkuros | 228755 | - |
dc.identifier.eissn | 1095-8673 | - |
dc.identifier.isi | WOS:000341358100020 | - |
dc.identifier.issnl | 0022-4804 | - |