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Comparison of Different Approaches of Endoscopic Thyroidectomy and Open Thyroidectomy: A Meta-analysis

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Abstract

Endoscopic thyroidectomy (ET) and its various approaches are widely used for benign and malignant thyroid nodules. Objective of our review is to compare endoscopic thyroidectomy (ET) and its various approaches with open thyroidectomy (OT) regarding safety and benefits. Electronic search was performed on MEDLINE (via PubMed) and the Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials (RCTs), well-designed cohorts, or case-controlled studies were included. Participants of any age and gender with a diagnosis of a thyroid nodule/goiter were included. We assessed the included trials using the Newcastle–Ottawa Scale to determine the methodological quality. Nineteen studies were included in this review. The risk of postoperative transient vocal cord palsy in ET was found to be higher than in OT (OR 4.47, 95% CI 2.92 to 6.86). Swallowing discomfort in ET was found to be much lower than OT (OR 0.06, 95% CI 0.01 to 0.31). No statistically significant difference was found in the risk of transient hypocalcemia, permanent hypocalcemia, permanent vocal cord palsy, hematoma/postoperative bleeding, seroma formation, and total complications. The operative time for ET was higher than for OT. The drain output after ET was higher than OT. Less number of lymph nodes were removed during ET compared to OT. No statistically significant difference was found in the length of hospital stay. ET can be used as a comparable replacement to OT in selected patients. ET is a safe technique with comparable long-term complications to OT.

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Data Availability

The data used for this meta analysis is available to public by the use of references provided in reference list.

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  1. Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India

    Komal Gupta & Kamal Kataria

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Gupta, K., Kataria, K. Comparison of Different Approaches of Endoscopic Thyroidectomy and Open Thyroidectomy: A Meta-analysis. Indian J Surg (2024). https://doi.org/10.1007/s12262-023-04002-9

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