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Transoral thyroidectomy vestibular approach vs. conventional open thyroidectomy: a systematic review and meta-analysis

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Abstract

The purpose of this study was to compare the intraoperative outcomes and postoperative complications of patients experiencing transoral thyroidectomy vestibular approach (TOTVA) and conventional open thyroidectomy (COT). PUBMED, EMBASE, the Cochrane Central Register of Controlled Trials in the Cochrane Library, and Web of science expanded between January 2007 and November 2022 comparing TOTVA and COT was exhaustively searched. Fifteen non-randomized controlled studies involving 2955 patients were included. The results of meta-analyses indicated that TOTVA was associated with longer operative time (WMD, 66.86; 95%CI, 47.15–86.56; P < 0.00001), more blood loss (WMD, 2.83; 95%CI, 1.77–3.90; P < 0.00001), higher incidence of wound infection (OR, 5.62; 95%CI, 1.57–20.10, P = 0.008). There was no significant difference in terms of transient recurrent laryngeal nerve (RLN) palsy and other postoperative outcomes. In conclusion, TOTVA appears to be a feasible and safe approach for the treatment of patients with benign thyroid nodules and selected differential thyroid carcinomas just like the COT.

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Author contributions

Z.L. and Y.W. designed the research. Y.W., D.W., and X.L. developed the literature search. Shengliang, Y.W., and X.L. carried out a statistical analysis of the studies. S.Z. and Y.W. drafted the article. All authors read and approved the final manuscript.

Funding

This work was supported by funding from the Sichuan Science and Technology Program (No. 2019YJ0038).

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Authors and Affiliations

  1. Department of Thyroid & Parathyroid Surgery Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

    Shengliang Zhou, Dun Wang, Zhihui Li & Yichao Wang

  2. West China School of Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

    Shengliang Zhou & Dun Wang

  3. Department of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

    Xueting Liu

  4. Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

    Zhihui Li & Yichao Wang

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  1. Shengliang Zhou
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Zhou, S., Wang, D., Liu, X. et al. Transoral thyroidectomy vestibular approach vs. conventional open thyroidectomy: a systematic review and meta-analysis. Endocrine 81, 36–46 (2023). https://doi.org/10.1007/s12020-023-03321-x

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