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Article: A systematic review and meta-analysis comparing outcomes between robotic-assisted thyroidectomy and non-robotic endoscopic thyroidectomy

TitleA systematic review and meta-analysis comparing outcomes between robotic-assisted thyroidectomy and non-robotic endoscopic thyroidectomy
Authors
KeywordsTotal thyroidectomy
Robotic thyroidectomy
Recurrent laryngeal nerve
Papillary thyroid carcinoma
Non-robotic thyroidectomy
Nerve monitoring
Hypoparathyroidism
Endoscopic thyroidectomy
Central neck dissection
Issue Date2014
PublisherElsevier 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?
AbstractBackground: 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 Identifierhttp://hdl.handle.net/10722/202218
ISSN
2015 Impact Factor: 2.198
2015 SCImago Journal Rankings: 0.928
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, BHH-
dc.contributor.authorWong, CKH-
dc.contributor.authorTsang, JS-
dc.contributor.authorWong, KP-
dc.date.accessioned2014-08-22T02:57:49Z-
dc.date.available2014-08-22T02:57:49Z-
dc.date.issued2014-
dc.identifier.citationJournal of Surgical Research, 2014, v. 191 n. 2, p. 389-398-
dc.identifier.issn0022-4804-
dc.identifier.urihttp://hdl.handle.net/10722/202218-
dc.description.abstractBackground: 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.languageeng-
dc.publisherElsevier Inc.. The Journal's web site is located at http://www.elsevier.com/locate/jsre-
dc.relation.ispartofJournal of Surgical Research-
dc.rightsNOTICE: 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.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectTotal thyroidectomy-
dc.subjectRobotic thyroidectomy-
dc.subjectRecurrent laryngeal nerve-
dc.subjectPapillary thyroid carcinoma-
dc.subjectNon-robotic thyroidectomy-
dc.subjectNerve monitoring-
dc.subjectHypoparathyroidism-
dc.subjectEndoscopic thyroidectomy-
dc.subjectCentral neck dissection-
dc.titleA systematic review and meta-analysis comparing outcomes between robotic-assisted thyroidectomy and non-robotic endoscopic thyroidectomy-
dc.typeArticle-
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.jss.2014.04.023-
dc.identifier.pmid24814766-
dc.identifier.scopuseid_2-s2.0-84908256622-
dc.identifier.hkuros228755-
dc.identifier.eissn1095-8673-
dc.identifier.isiWOS:000341358100020-

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