Zheng Chenhong, Liu Shouying, Geng Peiliang, Zhang Huiming, Zhang Hongpeng, Tang Airong, Xie Xiaohua
Department of Comprehensive Surgery, South Building, Chinese PLA General Hospital Beijing 100853, China ; Department of Chinese PLA General Logistics, No. 2 Clinic, Management Support Bureau Beijing 100071, China.
Department of Orthopedics, 253th Hospital of Chinese PLA #111 Aimin Road, Huhhot 010050, China.
Int J Clin Exp Med. 2015 Feb 15;8(2):2593-9. eCollection 2015.
The aim of this study was to compare the immune response between the minimally invasive video-assisted thyroidectomy (MIVAT) and conventional thyroidectomy (CT).
An exhaustive literature search was performed in the Medline, Embase, and Cochrane Library to identify the randomized controlled trials comparing the immune response between MIVAT and CT. Relevant data were extracted and statistical analysis was done using RevMan 5.0.
Twelve trials including 389 patients were identified. Immune-competent cells demonstrated no significant differences between MIVAT and CT. The including trails were assessed various perioperative plasma cytokine concentrations with no significant differences in interleukin-6 (IL-6), T lymphocytes (CD4(+), CD8(+), CD4/CD8) and NK cells between the MIVAT and CT. However, meta-analysis showed lower counts on postoperative days at 72 h was showed lower C-reactive protein (CRP) level compared to the preoperation levels but showed no significant difference within 24 h in MIVAT S group compared with CT group. Tumor necrosis factor alpha (TNF-α) level after surgery within 24 h and 72 h showed lower TNF-α level after MIVAT surgery within 24 h and 72 h.
This meta-analysis demonstrates that, MIVAT has less immune response outcomes and that it is a more ideal choice for the patients relative to the conventional surgery.
本研究旨在比较微创视频辅助甲状腺切除术（MIVAT）与传统甲状腺切除术（CT）之间的免疫反应。
在Medline、Embase和Cochrane图书馆进行了详尽的文献检索，以确定比较MIVAT和CT之间免疫反应的随机对照试验。提取相关数据并使用RevMan 5.0进行统计分析。
共纳入12项试验，389例患者。免疫活性细胞在MIVAT和CT之间无显著差异。纳入的试验评估了围手术期血浆细胞因子浓度，MIVAT和CT之间白细胞介素-6（IL-6）、T淋巴细胞（CD4(+)、CD8(+)、CD4/CD8）和NK细胞无显著差异。然而，荟萃分析显示，与术前水平相比，术后72小时C反应蛋白（CRP）水平较低，但MIVAT组与CT组在24小时内无显著差异。术后24小时和72小时肿瘤坏死因子α（TNF-α）水平显示，MIVAT术后24小时和72小时TNF-α水平较低。
这项荟萃分析表明，MIVAT的免疫反应结果较小，相对于传统手术，它对患者来说是更理想的选择。
