Department of Surgery, Thriassio General Hospital, Athens, Greece;
Hellenic Minimally Invasive and Robotic Surgery (MIRS) Study Group, Athens, Greece.
In Vivo. 2022 Jan-Feb;36(1):1-12. doi: 10.21873/invivo.12671.
This review focuses on complications linked to trans-oral endoscopic thyroidectomy via vestibular approach (TOETVA) and aimed to elucidate the procedure's initial safety profile. According to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), Pubmed, Embase, and the Cochrane databases were screened till May 2021. Twenty-eight articles, nine cohorts and nineteen case series, met the inclusion criteria. Procedure-related complications were analyzed, the most important being hypoparathyroidism: transient (range=0.94-22.2%), permanent (range=1.33-2.22%), and recurrent laryngeal nerve injury: transient (range=1.9-8.8%) and permanent (range=0.59-1.42%). Surgical trauma related complications, the most prevalent being seroma, emphysema, and hematoma accounted for 2.91%. Null mortality was reported. Although current evolving experience indicates that TOETVA is safe and linked to acceptable complication rates, the method needs to be compared with the gold standard of traditional thyroidectomy in the context of sufficiently numbered cohorts and ultimately randomized controlled trials.
这篇综述主要关注经口内镜甲状腺切除术（TOETVA）相关的并发症，并旨在阐明该术式的初始安全性特征。根据系统评价和荟萃分析的首选报告项目（PRISMA），我们对 Pubmed、Embase 和 Cochrane 数据库进行了筛选，截止日期为 2021 年 5 月。有 28 篇文章，9 个队列和 19 个病例系列符合纳入标准。分析了与手术相关的并发症，最重要的是甲状旁腺功能减退症：暂时性（范围为 0.94-22.2%）、永久性（范围为 1.33-2.22%）和喉返神经损伤：暂时性（范围为 1.9-8.8%）和永久性（范围为 0.59-1.42%）。手术创伤相关的并发症，最常见的是血清肿、气肿和血肿，占 2.91%。报告的死亡率为零。尽管目前不断发展的经验表明，TOETVA 是安全的，且相关并发症发生率可接受，但该方法需要在足够数量的队列中并最终在随机对照试验中与传统甲状腺切除术的金标准进行比较。
