Yin Si-Yue, Zhou Ping-Ting, Xie Zi-Hui, Shen Chuan-Lu, Li Fen-Fen, Liang Bing-Yu, Yang Yi-Pin, Fu Zi-Yue, Wang Jian-Peng, Han Yan-Xun, Chen Shan-Wen, Zhang Cong-Jun, Liu Ye-Hai, Zhao Yi, Liu Yu-Chen
Department of Oncology The First Affiliated Hospital of Anhui Medical University Hefei Anhui China.
Department of Otolaryngology, Head and Neck Surgery The First Affiliated Hospital of Anhui Medical University Hefei Anhui China.
OTO Open. 2025 May 2;9(2):e70120. doi: 10.1002/oto2.70120. eCollection 2025 Apr-Jun.
This umbrella review aims to evaluate the clinical outcomes of robotic-assisted thyroid surgery compared to traditional endoscopic and open surgical approaches.
We conducted a systematic search of PubMed, EMBASE, and Cochrane Database through August 2024.
We conducted a comprehensive analysis of systematic reviews and meta-analyses that compare robotic-assisted thyroid surgery with endoscopic or open methods. The primary outcomes assessed include surgical efficiency indicators, general postoperative complications, specific complications (nerve and endocrine), postoperative recovery and patient experience, and recurrence and long-term prognosis. The methodological quality of the included reviews was assessed using the AMSTAR2 tool.
Of the 1987 articles retrieved, 21 were eligible. Robotic surgery, though associated with longer operative times, offers distinct advantages in terms of precision. Although robotic surgery shows some variation in central lymph node dissection and an increase in postoperative drainage, its safety is comparable to both open and endoscopic techniques. Additionally, robotic surgery demonstrates superior cosmetic outcomes and shorter hospital stays from multiple approaches, though its high costs remain a significant factor. In terms of recurrence and survival rates, no significant differences were observed between robotic and open surgery.
Robotic surgery choices should balance benefits, costs, and patient needs. As technology and skills improve, efficiency and cost-effectiveness may increase, expanding its clinical role.
本系统评价旨在评估机器人辅助甲状腺手术与传统内镜手术和开放手术相比的临床结果。
我们对截至2024年8月的PubMed、EMBASE和Cochrane数据库进行了系统检索。
我们对比较机器人辅助甲状腺手术与内镜或开放手术方法的系统评价和荟萃分析进行了全面分析。评估的主要结局包括手术效率指标、一般术后并发症、特定并发症（神经和内分泌）、术后恢复和患者体验以及复发和长期预后。使用AMSTAR2工具评估纳入综述的方法学质量。
在检索到的1987篇文章中，21篇符合条件。机器人手术虽然手术时间较长，但在精度方面具有明显优势。尽管机器人手术在中央淋巴结清扫方面存在一些差异且术后引流增加，但其安全性与开放手术和内镜手术相当。此外，机器人手术从多种途径显示出更好的美容效果和更短的住院时间，不过其高昂的成本仍然是一个重要因素。在复发率和生存率方面，机器人手术和开放手术之间未观察到显著差异。
机器人手术的选择应在益处、成本和患者需求之间取得平衡。随着技术和技能的提高，效率和成本效益可能会增加，从而扩大其临床作用。
