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[微创视频辅助甲状腺切除术与传统甲状腺切除术治疗无淋巴结转移的甲状腺乳头状癌有效性和安全性比较的Meta分析]

[A Meta-analysis of comparing effectiveness and safety between minimally invasive video-assisted thyroidectomy and conventional thyroidectomy in the treatment of papillary thyroid carcinoma without lymph node metastasis].

作者信息

Zhang J, Yao K, Li K L

机构信息

Fuyang Clinical College of Anhui Medical University, Fuyang, 236000, China.

Department of Otolaryngology Head and Neck Surgery, Fuyang Hospital of Anhui Medical University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Sep 20;31(18):1435-1441. doi: 10.13201/j.issn.1001-1781.2017.18.014.

Abstract

To compare the effectiveness and safety between minimally invasive video-assisted thyroidectomy (MIVAT) and conventional thyroidectomy (CT) in the treatment of papillary thyroid carcinoma without lymph node metastasis, providing clinicians using video-assisted way to treat thyroid papillary carcinoma with a more reasonable basis.According to the including and excluding criterion,we searched the published articles which compare the effectiveness of MIVAT and CT curing PTC in randomized controlled clinical trials. The searching time was from January 2011 to December 2016, and the data was analyzed by using revman 5.3 software.Twelve articles involving 1 080 cases were included,and there were 514 cases in the MIVAT group and 566 cases in the CT group. The results of metaanalysis showed that: the operation time of MIVAT group is longer than that of CT group (=17.19, 95%12.43-21.96, <0.05); however the VAS point of MIVAT group is less than that of CT group in twentyfour hours after surgery (-1.07, 95%-1.61--0.53, <0.05). There is no significant difference in the incidences of transient recurrent laryngeal nerve injury(=2.21,95%0.9-5.07,>0.05),transient hypoparathyroidism (=0.78, 95%0.48-1.28, >0.05), serum thyroglobulin after five years followed up (-0.05, 95% -0.25-0.16, >0.05), number of retrieved central lymph nodes (=-0.36, 95% -0.72-0.01, >0.05) and number of retrieved central positive lymph nodes (=-0.15, 95%CI -0.45-0.16, >0.05).Using MIVAT treating papillary thyroid carcinoma (without lymph node metastasis) is safe when its indications are strictly controlled.

摘要

为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)治疗无淋巴结转移的甲状腺乳头状癌的有效性和安全性,为临床医生采用视频辅助方式治疗甲状腺乳头状癌提供更合理的依据。根据纳入和排除标准,检索在随机对照临床试验中比较MIVAT和CT治疗PTC有效性的已发表文章。检索时间为2011年1月至2016年12月,数据采用revman 5.3软件进行分析。纳入12篇文章,共1080例病例,其中MIVAT组514例,CT组566例。Meta分析结果显示:MIVAT组手术时间长于CT组(=17.19,95% 12.43 - 21.96,<0.05);但MIVAT组术后24小时VAS评分低于CT组(-1.07,95% -1.61 - -0.53,<0.05)。暂时性喉返神经损伤发生率(=2.21,95% 0.9 - 5.07,>0.05)、暂时性甲状旁腺功能减退发生率(=0.78,95% 0.48 - 1.28,>0.05)、随访5年后血清甲状腺球蛋白(-0.05,95% -0.25 - 0.16,>0.05)、中央区淋巴结清扫数目(=-0.36,95% -0.72 - 0.01,>0.05)及中央区阳性淋巴结数目(=-0.15,95%CI -0.45 - 0.16,>0.05)差异均无统计学意义。严格掌握适应证时,采用MIVAT治疗甲状腺乳头状癌(无淋巴结转移)是安全的。

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