Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
West China School of Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
Endocrine. 2023 Jul;81(1):36-46. doi: 10.1007/s12020-023-03321-x. Epub 2023 Feb 24.
The purpose of this study was to compare the intraoperative outcomes and postoperative complications of patients experiencing transoral thyroidectomy vestibular approach (TOTVA) and conventional open thyroidectomy (COT). PUBMED, EMBASE, the Cochrane Central Register of Controlled Trials in the Cochrane Library, and Web of science expanded between January 2007 and November 2022 comparing TOTVA and COT was exhaustively searched. Fifteen non-randomized controlled studies involving 2955 patients were included. The results of meta-analyses indicated that TOTVA was associated with longer operative time (WMD, 66.86; 95%CI, 47.15-86.56; P < 0.00001), more blood loss (WMD, 2.83; 95%CI, 1.77-3.90; P < 0.00001), higher incidence of wound infection (OR, 5.62; 95%CI, 1.57-20.10, P = 0.008). There was no significant difference in terms of transient recurrent laryngeal nerve (RLN) palsy and other postoperative outcomes. In conclusion, TOTVA appears to be a feasible and safe approach for the treatment of patients with benign thyroid nodules and selected differential thyroid carcinomas just like the COT.
本研究旨在比较经口甲状腺切除术前庭入路（TOTVA）与传统开放甲状腺切除术（COT）的术中结果和术后并发症。系统检索了 2007 年 1 月至 2022 年 11 月 PUBMED、EMBASE、Cochrane 图书馆中的 Cochrane 对照试验中心注册库和 Web of Science 扩展版中比较 TOTVA 和 COT 的非随机对照研究。共纳入 15 项非随机对照研究，涉及 2955 例患者。荟萃分析结果表明，TOTVA 与手术时间更长（WMD，66.86；95%CI，47.15-86.56；P<0.00001）、术中出血量更多（WMD，2.83；95%CI，1.77-3.90；P<0.00001）、切口感染发生率更高（OR，5.62；95%CI，1.57-20.10，P=0.008）相关。在暂时性喉返神经（RLN）麻痹和其他术后结果方面，两组间无显著差异。总之，TOTVA 似乎是治疗良性甲状腺结节和选定的分化型甲状腺癌患者的一种可行且安全的方法，与 COT 相似。
