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Transoral thyroidectomy vestibular approach versus non-transoral endoscopic thyroidectomy: a comprehensive systematic review and meta-analysis

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Abstract

Background

To conduct a meta-analysis to compare the short-term outcomes of transoral thyroidectomy vestibular approach (TOTVA) with non-transoral endoscopic thyroidectomy (NTET).

Methods

MEDLINE, EMBASE, science citation index expanded, and the Cochrane Central Register of Controlled Trials in the Cochrane Library from January 2007 to January 2021 were searched for relevant literature. The evaluated endpoints were intra-operative and post-operative outcomes.

Results

Ten eligible, non-randomized comparative studies involving 1677 patients were included. Meta-analysis results revealed that TOTVA was associated with significantly longer operative time [weighted mean differences (WMD), 22.60; 95%confidence interval (CI), 7.51–37.69; P = 0.003]. No significant differences were found between TOTVA group and NTET group in terms of post-operative outcomes.

Conclusion

TOTVA appears to be an equally feasible and safe surgical procedure as NTET for patients with benign thyroid nodules and selected differentiated thyroid carcinomas.

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Funding

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

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Author notes

  1. Dun Wang and Yichao Wang have contributed equally to this work and are co-first authors.

Authors and Affiliations

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

    Dun Wang, Yichao Wang, Shengliang Zhou, Tao Wei, Jingqiang Zhu & Zhihui Li

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

    Dun Wang & Shengliang Zhou

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

    Xueting Liu

Authors
  1. Dun Wang
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  5. Tao Wei
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Contributions

ZL, TW, and JZ designed the research. YW and DW developed the literature search. DW, YW, and XL carried out statistical analysis of the studies. DW and YW drafted the article. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zhihui Li.

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Disclosures

Dr. Dun Wang, Dr. Yichao Wang, Dr. Shengliang Zhou, Dr. Xueting Liu, Dr. Tao Wei, Dr. Jingqiang Zhu, and Dr. Zhihui Li have no conflict of interest or financial ties to disclose.

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Wang, D., Wang, Y., Zhou, S. et al. Transoral thyroidectomy vestibular approach versus non-transoral endoscopic thyroidectomy: a comprehensive systematic review and meta-analysis. Surg Endosc 36, 1739–1749 (2022). https://doi.org/10.1007/s00464-021-08836-w

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  • DOI: https://doi.org/10.1007/s00464-021-08836-w

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