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Transoral endoscopic thyroidectomy vestibular approach vs. transoral robotic thyroidectomy: systematic review and meta-analysis

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Abstract

This study aimed to conduct a systematic review and meta-analysis to compare the surgical outcomes of the transoral endoscopic thyroidectomy vestibular approach (TOETVA) and transoral robotic thyroidectomy (TORT). We carried out a systematic literature search of PubMed, Web of Science, Cochrane Library, and Google Scholar on studies comparing TOETVA and TORT until January 2023. A total of five articles published between 2018 and 2023 that matched the inclusion criteria were included in the systematic review and meta-analysis. The studies included 641 patients (394 TOETVA patients and 247 TORT patients). TOETVA group was associated with a significantly shorter operative time with a mean difference of 60.08 min [95% confidence interval (CI) − 83.95 to − 36.20; P < 0.001). Transient recurrent laryngeal nerve palsy was more common in the TOETVA group than the TORT group (OR 3.00; 95% CI 1.14–7.88; P = 0.03). There were no significant differences in the other outcomes, including the length of hospital stay, postoperative pain scores, number of central lymph nodes retrieved, permanent recurrent laryngeal nerve injuries, and transient and permanent hypoparathyroidism. The TOETVA group was associated with shorter operative time and more transient recurrent laryngeal nerve palsy than the TORT group. Each procedure has its benefits and limitations. The surgical approach should be determined by considering the patient’s characteristics and preferences, as well as the surgeon’s preference and area of expertise.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea

    Moon Young Oh & Young Jun Chai

  2. Transdisciplinary Department of Medicine and Advanced Technology, Seoul National University Hospital, Seoul, Korea

    Young Jun Chai

  3. Department of Surgery, Seoul National University Bundang Hospital, Seongnam-Si, South Korea

    Hyeong Won Yu & June Young Choi

  4. Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Su-Jin Kim & Kyu Eun Lee

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  1. Moon Young Oh
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Correspondence to Young Jun Chai.

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Moon Young Oh, Young Jun Chai, Hyeong Won Yu, Su-Jin Kim, June Young Choi, Kyu Eun Lee have no conflict of interest or financial ties to disclose.

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Oh, M.Y., Chai, Y.J., Yu, H.W. et al. Transoral endoscopic thyroidectomy vestibular approach vs. transoral robotic thyroidectomy: systematic review and meta-analysis. Updates Surg 75, 1773–1781 (2023). https://doi.org/10.1007/s13304-023-01623-3

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