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Article: A systematic review and meta-analysis evaluating completeness and outcomes of robotic thyroidectomy

TitleA systematic review and meta-analysis evaluating completeness and outcomes of robotic thyroidectomy
Authors
Issue Date2015
PublisherJohn 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?
AbstractOBJECTIVES/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 Identifierhttp://hdl.handle.net/10722/205973
ISSN
2015 Impact Factor: 2.272
2015 SCImago Journal Rankings: 1.342

 

DC FieldValueLanguage
dc.contributor.authorLang, HHBen_US
dc.contributor.authorWong, CKHen_US
dc.contributor.authorTsang, JSen_US
dc.contributor.authorWong, KPen_US
dc.contributor.authorWan, KYen_US
dc.date.accessioned2014-10-20T10:37:59Z-
dc.date.available2014-10-20T10:37:59Z-
dc.date.issued2015en_US
dc.identifier.citationThe Laryngoscope, 2015, v. 125 n. 2, p. 509-518en_US
dc.identifier.issn0023-852X-
dc.identifier.urihttp://hdl.handle.net/10722/205973-
dc.description.abstractOBJECTIVES/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.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.laryngoscope.com/-
dc.relation.ispartofThe Laryngoscopeen_US
dc.rightsThe Laryngoscope. Copyright © John Wiley & Sons, Inc.-
dc.rightsThis is a preprint of an article published in The Laryngoscope, 2015, v. 125 n. 2, p. 509-518-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleA systematic review and meta-analysis evaluating completeness and outcomes of robotic thyroidectomyen_US
dc.typeArticleen_US
dc.identifier.emailLang, HHB: Blang@hku.hken_US
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.authorityLang, HHB=rp01828en_US
dc.description.naturepostprint-
dc.identifier.doi10.1002/lary.24946-
dc.identifier.pmid25236330-
dc.identifier.hkuros241259en_US
dc.identifier.volume125en_US
dc.identifier.issue2-
dc.identifier.spage509-
dc.identifier.epage518-
dc.publisher.placeUnited States-

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