经口内镜甲状腺切除术前庭入路与传统开放甲状腺切除术的安全性和有效性：系统评价和荟萃分析。

Safety and Efficacy of Transoral Endoscopic Thyroidectomy Vestibular Approach Versus Conventional Open Thyroidectomy: A Systematic Review and Meta-analysis.

机构信息

Departments of Breast and Thyroid Surgery.

Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.

出版信息

Surg Laparosc Endosc Percutan Tech. 2023 Oct 1;33(5):547-555. doi: 10.1097/SLE.0000000000001197.

DOI:10.1097/SLE.0000000000001197

PMID:37523575

Abstract

OBJECTIVE

To evaluate the safety and efficacy of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) versus conventional open thyroidectomy (COT) for some thyroid diseases.

MATERIALS AND METHODS

Databases PubMed, Embase, and Web of Science were searched. Full-text English papers that described TOETVA and COT for people with thyroid diseases were included. Randomized, nonrandomized, controlled, and uncontrolled trials were all included. Extracted data included population characteristics and intraoperative and postoperative complications.

RESULTS

A total of 2 randomized controlled trials and 10 retrospective studies, including 3048 patients, were included in the meta-analysis. Meta-analysis results suggested that the intraoperative conditions and postoperative complication rates did not differ significantly between the two groups. However, in the TOETVA group, there is a slightly longer operative time [weighted mean difference (WMD): 73.64; 95% CI: 49.34 to 97.94; P < 0.0001], drainage (WMD: 91.0; 95% CI: 35.52 to 146.48; P = 0.001), and hospital stay (WMD: 0.28; 95% CI: 0.18 to 0.38; P < 0.0001).

CONCLUSION

For most of the benign thyroid nodules and selected patients with papillary thyroid cancer, TOETVA seems to be as feasible and safe as COT.

摘要

目的

评估经口内镜甲状腺切除术经前庭入路（TOETVA）与传统开放式甲状腺切除术（COT）治疗某些甲状腺疾病的安全性和疗效。

材料和方法

检索PubMed、Embase 和 Web of Science 数据库。纳入描述 TOETVA 和 COT 治疗甲状腺疾病患者的全文英文文献。包括随机、非随机、对照和非对照试验。提取的数据包括人口统计学特征以及术中及术后并发症。

结果

共纳入 2 项随机对照试验和 10 项回顾性研究，共 3048 例患者纳入荟萃分析。荟萃分析结果表明，两组患者的术中情况和术后并发症发生率无显著差异。然而，在 TOETVA 组，手术时间稍长[加权均数差（WMD）：73.64；95%可信区间（CI）：49.34 至 97.94；P < 0.0001]，引流时间（WMD：91.0；95% CI：35.52 至 146.48；P = 0.001）和住院时间（WMD：0.28；95% CI：0.18 至 0.38；P < 0.0001）较长。