Robotic thyroidectomy versus endoscopic thyroidectomy: a meta-analysis
To conduct a meta-analysis to determine the relative merits of robotic thyroidectomy (RT) and endoscopic thyroidectomy (ET).
A literature search was performed to identify comparative studies reporting peri-operative outcomes for RT and ET. Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence interval (95% CI) were calculated using either a fixed-effects or a random-effects model.
Six studies matched the selection criteria, which reported on 2048 subjects, of whom 978 underwent RT and 1070 underwent ET. Comparing the outcomes of RT with ET, this meta-analysis indicated that RT was associated with more complications (WMD = 1.51, 95% CI 1.18 to 1.94) and greater amount of drainage fluid (WMD = 17.10, 95% CI 5.69 to 28.51). Meanwhile, operating time (WMD = 1.50, 95% CI −39.59 to 42.58), conversion (WMD = 0.63, 95% CI 0.07 to 6.17), post-operative hospital stay (WMD = −0.05; 95% CI −0.18 to 0.08), and the number of lymph nodes harvested (WMD = 0.62, 95% CI −0.29 to 1.53) were similar for both procedures.
The results of this meta-analysis indicated that RT is associated with an increased risk of complications and a greater amount of drainage fluid. Therefore, RT does not appear to have any advantage over ET. Further studies are required to confirm these results.
- Hüscher, CS, Chiodini, S, Napolitano, C, Recher, A (1997) Endoscopic right thyroid lobectomy. Surg Endosc 11: pp. 877 CrossRef
- Jeong, JJ, Kang, SW, Yun, JS, Sung, TY, Lee, SC, Lee, YS, Nam, KH, Chang, HS, Chung, WY, Park, CS (2009) Comparative study of endoscopic thyroidectomy versus conventional open thyroidectomy in papillary thyroid microcarcinoma (PTMC) patients. J Surg Oncol 100: pp. 477-480 CrossRef
- Ujiki, MB, Sturgeon, C, Denham, D, Yip, L, Angelos, P (2006) Minimally invasive video-assisted thyroidectomy for follicular neoplasm: is there an advantage over conventional thyroidectomy?. Ann Surg Oncol 13: pp. 182-186 CrossRef
- Chen, XD, Peng, B, Gong, RX, Wang, L, Liao, B, Li, CL (2008) Endoscopic thyroidectomy: an evidence-based research on feasibility, safety and clinical effectiveness. Chin Med J (Engl) 121: pp. 2088-2094
- Choi, JY, Lee, KE, Chung, KW, Kim, SW, Choe, JH, Koo do, H, Kim, SJ, Lee, J, Chung, YS, Oh, SK, Youn, YK (2012) Endoscopic thyroidectomy via bilateral axillo-breast approach (BABA): review of 512 cases in a single institute. Surg Endosc 26: pp. 948-955 CrossRef
- Lin, S, Jiang, HG, Chen, ZH, Zhou, SY, Liu, XS, Yu, JR (2011) Meta-analysis of robotic and laparoscopic surgery for treatment of rectal cancer. World J Gastroenterol 17: pp. 5214-5220 CrossRef
- Maeso, S, Reza, M, Mayol, JA, Blasco, JA, Guerra, M, Andradas, E, Plana, MN (2010) Efficacy of the Da Vinci surgical system in abdominal surgery compared with that of laparoscopy: a systematic review and meta-analysis. Ann Surg 252: pp. 254-262 CrossRef
- Benmessaoud, C, Kharrazi, H, MacDorman, KF (2011) Facilitators and barriers to adopting robotic-assisted surgery: contextualizing the unified theory of acceptance and use of technology. PLoS One 6: pp. e16395 CrossRef
- Kang, SW, Park, JH, Jeong, JS, Lee, CR, Park, S, Lee, SH, Jeong, JJ, Nam, KH, Chung, WY, Park, CS (2011) Prospects of robotic thyroidectomy using a gasless, transaxillary approach for the management of thyroid carcinoma. Surg Laparosc Endosc Percutan Tech 21: pp. 223-229 CrossRef
- Lee, KE, Koo do, H, Kim, SJ, Lee, J, Park, KS, Oh, SK, Youn, YK (2010) Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery 148: pp. 1207-1213 CrossRef
- Yoo, H, Chae, BJ, Park, HS, Kim, KH, Kim, SH, Song, BJ, Jung, SS, Bae, JS (2012) Comparison of surgical outcomes between endoscopic and robotic thyroidectomy. J Surg Oncol 105: pp. 705-708 CrossRef
- Tae, K, Bae Ji, Y, Hyeok Jeong, J, Rae Kim, K, Hwan Choi, W, Hern Ahn, Y (2012) Comparative study of robotic versus endoscopic thyroidectomy by a gasless unilateral axillo-breast or axillary approach. Head Neck.
- Lee, S, Ryu, HR, Park, JH, Kim, KH, Kang, SW, Jeong, JJ, Nam, KH, Chung, WY, Park, CS (2011) Excellence in robotic thyroid surgery: a comparative study of robot-assisted versus conventional endoscopic thyroidectomy in papillary thyroid microcarcinoma patients. Ann Surg 253: pp. 1060-1066 CrossRef
- Lee, J, Lee, JH, Nah, KY, Soh, EY, Chung, WY (2011) Comparison of endoscopic and robotic thyroidectomy. Ann Surg Oncol 18: pp. 1439-1446 CrossRef
- Lang, BH, Chow, MP (2011) A comparison of surgical outcomes between endoscopic and robotically assisted thyroidectomy: the authors’ initial experience. Surg Endosc 25: pp. 1617-1623 CrossRef
- Kim, WW, Kim, JS, Hur, SM, Kim, SH, Lee, SK, Choi, JH, Kim, S, Lee, JE, Kim, JH, Nam, SJ, Yang, JH, Choe, JH (2011) Is robotic surgery superior to endoscopic and open surgeries in thyroid cancer?. World J Surg 35: pp. 779-784 CrossRef
- Aziz, O, Constantinides, V, Tekkis, PP, Athanasiou, T, Purkayastha, S, Paraskeva, P, Darzi, AW, Heriot, AG (2006) Laparoscopic versus open surgery for rectal cancer: a meta-analysis. Ann Surg Oncol 13: pp. 413-424 CrossRef
- Mathurin, P, Raynard, B, Dharancy, S, Kirzin, S, Fallik, D, Pruvot, FR, Roumilhac, D, Canva, V, Paris, JC, Chaput, JC, Naveau, S (2003) Meta-analysis: evaluation of adjuvant therapy after curative liver resection for hepatocellular carcinoma. Aliment Pharmacol Ther 17: pp. 1247-1261 CrossRef
- Zhou, Y, Zhao, Y, Li, B, Xu, D, Yin, Z, Xie, F, Yang, J (2010) Meta-analysis of radiofrequency ablation versus hepatic resection for small hepatocellular carcinoma. BMC Gastroenterol 10: pp. 78 CrossRef
- Ng, SS, Lee, JF, Yiu, RY, Li, JC, Hon, SS (2007) Telerobotic-assisted laparoscopic abdominoperineal resection for low rectal cancer: report of the first case in Hong Kong and China with an updated literature review. World J Gastroenterol 13: pp. 2514-2518
- Mazzaferri, EL (1987) Papillary thyroid carcinoma: factors influencing prognosis and current therapy. Semin Oncol 14: pp. 315-332
- Bhattacharyya, N (2003) Surgical treatment of cervical nodal metastases in patients with papillary thyroid carcinoma. Arch Otolaryngol Head Neck Surg 129: pp. 1101-1104 CrossRef
- MacLehose, RR, Reeves, BC, Harvey, IM, Sheldon, TA, Russell, IT, Black, AM (2000) A systematic review of comparisons of effect sizes derived from randomised and non-randomised studies. Health Technol Assess 4: pp. 1-154
- Abraham, NS, Byrne, CJ, Young, JM, Solomon, MJ (2010) Meta-analysis of well-designed nonrandomized comparative studies of surgical procedures is as good as randomized controlled trials. J Clin Epidemiol 63: pp. 238-245 CrossRef
- Robotic thyroidectomy versus endoscopic thyroidectomy: a meta-analysis
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
World Journal of Surgical Oncology
- Online Date
- November 2012
- Online ISSN
- BioMed Central
- Additional Links
- Robotic thyroidectomy
- Endoscopic thyroidectomy
- Da Vinci robotic system
- Author Affiliations
- 1. Department of Oncological surgery, First Affiliated Hospital of Jiaxing University, Jiaxing, 314000, Zhejiang Province, China
- 2. Department of Surgery, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou, 310003, Zhejiang Province, China