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Article: A systematic review and meta-analysis evaluating completeness and outcomes of robotic thyroidectomy
Title | A systematic review and meta-analysis evaluating completeness and outcomes of robotic thyroidectomy |
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Authors | |
Keywords | Central lymph nodes Papillary thyroid carcinoma Radioactive iodine Robotic thyroidectomy Thyroglobulin Total thyroidectomy |
Issue Date | 2015 |
Publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/ |
Citation | The Laryngoscope, 2015, v. 125 n. 2, p. 509-518 How to Cite? |
Abstract | OBJECTIVES/HYPOTHESIS:
Despite immense interest, robotic-assisted thyroidectomy (RT) remains controversial in differentiated thyroid carcinoma (DTC). This systematic review and meta-analysis compared surgical completeness and/or oncological outcomes between RT and open thyroidectomy (OT) in low-risk DTC.
STUDY DESIGN:
Systematic review.
METHODS:
A systematic review was performed to identify studies that compared surgical completeness and/or oncological outcomes between RT and OT in DTC. Any study that compared at least one parameter relating to surgical completeness and/or oncological outcome for DTC was considered. Number of central lymph nodes (CLNs) retrieved during central neck dissection (CND), preablation stimulated thyroglobulin (sTg) level, radioiodine uptake on post-therapy scan, and locoregional recurrence (LRR) were examined. Meta-analysis was performed using a fixed or random-effects model depending on heterogeneity between studies.
RESULTS:
Ten studies were eligible. Of the 2,205 DTCs, 752 (34.1%) had RT, whereas 1,453 (65.9%) had OT. Relative to OT, RT had signif icantly fewer CLNs retrieved during CND (4.7 ± 3.2 vs. 5.5 ± 3.8, standardized mean difference [SMD] = -0.240, 95% confidence interval [CI]: -0.364 to -0.116, P < .001) and higher preablation sTg level (3.6 ± 6.7 ng/mL vs. 2.0 ± 5.0 ng/mL, SMD = 0.272, 95% CI: 0.022 to 0.522, P = .033). Interestingly, these differences were more evident in the robotic transaxillary approach (RTAA) than the robotic bilateral axillo-breast approach. After a mean follow-up of 17.7 months, no LRR was found in RT, whereas after 18.6 months, one LRR was found in OT.
CONCLUSIONS:
Relative to OT, total thyroidectomy by RTAA was associated with fewer CLNs retrieved and less-complete thyroid resection. However, using RTAA is unlikely to compromise the outcomes of low-risk DTC because of its inherently good prognosis. Laryngoscope, 125:509-518, 2015.
© 2014 The American Laryngological, Rhinological and Otological Society, Inc. |
Persistent Identifier | http://hdl.handle.net/10722/205973 |
ISSN | 2023 Impact Factor: 2.2 2023 SCImago Journal Rankings: 1.128 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lang, HHB | en_US |
dc.contributor.author | Wong, CKH | en_US |
dc.contributor.author | Tsang, JS | en_US |
dc.contributor.author | Wong, KP | en_US |
dc.contributor.author | Wan, KY | en_US |
dc.date.accessioned | 2014-10-20T10:37:59Z | - |
dc.date.available | 2014-10-20T10:37:59Z | - |
dc.date.issued | 2015 | en_US |
dc.identifier.citation | The Laryngoscope, 2015, v. 125 n. 2, p. 509-518 | en_US |
dc.identifier.issn | 0023-852X | - |
dc.identifier.uri | http://hdl.handle.net/10722/205973 | - |
dc.description.abstract | OBJECTIVES/HYPOTHESIS: Despite immense interest, robotic-assisted thyroidectomy (RT) remains controversial in differentiated thyroid carcinoma (DTC). This systematic review and meta-analysis compared surgical completeness and/or oncological outcomes between RT and open thyroidectomy (OT) in low-risk DTC. STUDY DESIGN: Systematic review. METHODS: A systematic review was performed to identify studies that compared surgical completeness and/or oncological outcomes between RT and OT in DTC. Any study that compared at least one parameter relating to surgical completeness and/or oncological outcome for DTC was considered. Number of central lymph nodes (CLNs) retrieved during central neck dissection (CND), preablation stimulated thyroglobulin (sTg) level, radioiodine uptake on post-therapy scan, and locoregional recurrence (LRR) were examined. Meta-analysis was performed using a fixed or random-effects model depending on heterogeneity between studies. RESULTS: Ten studies were eligible. Of the 2,205 DTCs, 752 (34.1%) had RT, whereas 1,453 (65.9%) had OT. Relative to OT, RT had signif icantly fewer CLNs retrieved during CND (4.7 ± 3.2 vs. 5.5 ± 3.8, standardized mean difference [SMD] = -0.240, 95% confidence interval [CI]: -0.364 to -0.116, P < .001) and higher preablation sTg level (3.6 ± 6.7 ng/mL vs. 2.0 ± 5.0 ng/mL, SMD = 0.272, 95% CI: 0.022 to 0.522, P = .033). Interestingly, these differences were more evident in the robotic transaxillary approach (RTAA) than the robotic bilateral axillo-breast approach. After a mean follow-up of 17.7 months, no LRR was found in RT, whereas after 18.6 months, one LRR was found in OT. CONCLUSIONS: Relative to OT, total thyroidectomy by RTAA was associated with fewer CLNs retrieved and less-complete thyroid resection. However, using RTAA is unlikely to compromise the outcomes of low-risk DTC because of its inherently good prognosis. Laryngoscope, 125:509-518, 2015. © 2014 The American Laryngological, Rhinological and Otological Society, Inc. | - |
dc.language | eng | en_US |
dc.publisher | John Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/ | - |
dc.relation.ispartof | The Laryngoscope | en_US |
dc.rights | The Laryngoscope. Copyright © John Wiley & Sons, Inc. | - |
dc.rights | This is a preprint of an article published in The Laryngoscope, 2015, v. 125 n. 2, p. 509-518 | - |
dc.subject | Central lymph nodes | - |
dc.subject | Papillary thyroid carcinoma | - |
dc.subject | Radioactive iodine | - |
dc.subject | Robotic thyroidectomy | - |
dc.subject | Thyroglobulin | - |
dc.subject | Total thyroidectomy | - |
dc.title | A systematic review and meta-analysis evaluating completeness and outcomes of robotic thyroidectomy | en_US |
dc.type | Article | en_US |
dc.identifier.email | Lang, HHB: Blang@hku.hk | en_US |
dc.identifier.email | Wong, CKH: carlosho@hku.hk | - |
dc.identifier.authority | Lang, HHB=rp01828 | en_US |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1002/lary.24946 | - |
dc.identifier.pmid | 25236330 | - |
dc.identifier.scopus | eid_2-s2.0-84921629036 | - |
dc.identifier.hkuros | 241259 | en_US |
dc.identifier.volume | 125 | en_US |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 509 | - |
dc.identifier.epage | 518 | - |
dc.identifier.isi | WOS:000349973400054 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0023-852X | - |