Inner Mongolia Medical University, Department of Thyroid and Breast Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, North Street, Inner Mongolia, 010050, China.
Inner Mongolia Medical University, Department of Thyroid and Breast Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, North Street, Inner Mongolia, 010050, China.
Asian J Surg. 2024 Mar;47(3):1344-1350. doi: 10.1016/j.asjsur.2023.12.037. Epub 2023 Dec 11.
Endoscopic thyroidectomy (ET), a surgical procedure widely accepted by surgeons, has been proven to be feasible. The aim of this systematic review is to evaluate the effectiveness and safety of ET compared to conventional open thyroidectomy (COT) in the treatment of papillary thyroid microcarcinoma (PTMC) through a meta-analysis. Medical literature databases, including PubMed, Embase, Cochrane Library, CBM,CNKI, Wanfang, and VIP, were systematically searched for relevant studies on ET and COT for the treatment of PTMC. The search period was from January 2000 to June 2023. Two researchers independently performed literature screening and data extraction according to the inclusion and exclusion criteria, and the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Meta-analysis was conducted using Revman 5.3 software. Six studies were eventually included, involving a total of 440 patients with PTMC. The meta-analysis results demonstrated that the ET group had shorter incision length (MD = -2.96, 95 % CI: -4.27 to -1.65, P < 0.05) and less intraoperative blood loss (MD = -18.06, 95 % CI: -32.76 to -3.37, P = 0.02 < 0.05). There was no statistically significant difference between the two groups in terms of operative time (MD = -0.83, 95 % CI: -19.64 to 17.98, P = 0.93 > 0.05), lymph node dissection (MD = 1.03, 95 % CI: -1.47 to 3.54, P = 0.42 > 0.05), postoperative hospital stay (MD = -0.96, 95 % CI: -2.00 to 0.08, P = 0.07 > 0.05), and transient recurrent laryngeal nerve paralysis (OR = 3.32, 95 % CI: 0.65 to 16.90, P = 0.15 > 0.05). Compared with COT, ET has the advantages of shorter incision length, less intraoperative blood loss, better prognosis and comparable safety, making it a worthy choice for clinical application.
内镜甲状腺切除术（ET）是一种被外科医生广泛接受的手术方法，已被证明是可行的。本系统评价的目的是通过荟萃分析评估 ET 与传统开放甲状腺切除术（COT）治疗甲状腺微小乳头状癌（PTMC）的有效性和安全性。我们系统地检索了包括 PubMed、Embase、Cochrane 图书馆、CBM、CNKI、万方和 VIP 在内的医学文献数据库，以获取有关 ET 和 COT 治疗 PTMC 的相关研究。检索时间为 2000 年 1 月至 2023 年 6 月。两名研究人员根据纳入和排除标准独立进行文献筛选和数据提取，并使用纽卡斯尔-渥太华量表（NOS）评估纳入研究的质量。使用 RevMan 5.3 软件进行荟萃分析。最终纳入了 6 项研究，共纳入 440 例 PTMC 患者。荟萃分析结果表明，ET 组的切口长度更短（MD=-2.96，95%CI：-4.27 至-1.65，P<0.05），术中出血量更少（MD=-18.06，95%CI：-32.76 至-3.37，P=0.02<0.05）。两组在手术时间（MD=-0.83，95%CI：-19.64 至 17.98，P=0.93>0.05）、淋巴结清扫术（MD=1.03，95%CI：-1.47 至 3.54，P=0.42>0.05）、术后住院时间（MD=-0.96，95%CI：-2.00 至 0.08，P=0.07>0.05）和暂时性喉返神经麻痹（OR=3.32，95%CI：0.65 至 16.90，P=0.15>0.05）方面无统计学差异。与 COT 相比，ET 具有切口长度短、术中出血量少、预后更好且安全性相当的优点，是一种有临床应用价值的选择。
