文献类型：期刊文献

英文题名：Comparison of total endoscopic thyroidectomy with conventional open thyroidectomy for treatment of papillary thyroid cancer: a systematic review and meta-analysis

作者：Jiang, Wen-Jie[1,4];Yan, Pei-Jing[4];Zhao, Chun-Lin[6];Si, Mou-Bo[1,2,4];Tian, Wen[7];Zhang, Yan-Jun[7];Tian, Hong-Wei[2];Feng, Shuang-Wu[1];Han, Cai-Wen[2,4];Yang, Jia[2,4];Yang, Ke-Hu[1,3,4,5];Guo, Tian-Kang[1,2,4]

第一作者：Jiang, Wen-Jie

通信作者：Yang, KH[1];Guo, TK[1];Guo, TK[2];Yang, KH[3];Yang, KH[4];Guo, TK[4];Yang, KH[5]

机构：[1]Lanzhou Univ, Clin Med Coll 1, Lanzhou 730000, Peoples R China;[2]Gansu Prov Hosp, Dept Gen Surg, Donggang West Rd, Lanzhou 730000, Peoples R China;[3]Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, 199 Donggang West Rd, Lanzhou 730000, Peoples R China;[4]Gansu Prov Hosp, Inst Clin Res & Evidence Based Med, Lanzhou 730000, Peoples R China;[5]Key Lab Evidence Based Med & Knowledge Translat G, Lanzhou 730000, Gansu, Peoples R China;[6]Gansu Univ Tradit Chinese Med, Affiliated Hosp, Lanzhou 730000, Gansu, Peoples R China;[7]Peoples Liberat Army Gen Hosp, Ctr Clin 1, Dept Gen Surg, Beijing 100000, Peoples R China

第一机构：Lanzhou Univ, Clin Med Coll 1, Lanzhou 730000, Peoples R China

通信机构：[1]corresponding author), Lanzhou Univ, Clin Med Coll 1, Lanzhou 730000, Peoples R China;[2]corresponding author), Gansu Prov Hosp, Dept Gen Surg, Donggang West Rd, Lanzhou 730000, Peoples R China;[3]corresponding author), Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, 199 Donggang West Rd, Lanzhou 730000, Peoples R China;[4]corresponding author), Gansu Prov Hosp, Inst Clin Res & Evidence Based Med, Lanzhou 730000, Peoples R China;[5]corresponding author), Key Lab Evidence Based Med & Knowledge Translat G, Lanzhou 730000, Gansu, Peoples R China.

年份：2020

卷号：34

期号：5

起止页码：1891

外文期刊名：SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES

收录：;Scopus(收录号：2-s2.0-85081210083);WOS:【SCI-EXPANDED(收录号:WOS:000522996200001)】；

基金：Supported by Gansu Province Science & Technology support program of Science and Technology department of Gansu Province (Grant No. 144FKCA073). Supported by Key Laboratory of Evidence Based Medicine and Knowledge Translation Foundation of Gansu Province(Grant No. GSXZYZH2018006). Supported by Foundation of Lanzhou Science and Technology Bureau (Grant No. 2017-ZD-38). Supported by Research Projects of Affiliated hospital of gansu university of traditional Chinese medicine (Grant No. gzfy-2017-09)

语种：英文

外文关键词：Laparoscopy; Thyroidectomy; Open; Thyroid cancer; Recurrence rate; Meta-analysis

摘要：Background Despite the fact that thyroid surgery has evolved towards minimal incisions and endoscopic approaches, the role of total endoscopic thyroidectomy (TET) in thyroid cancer has been highly disputed. We performed a systematic review and meta-analyses of peer reviewed studies in order to evaluate the safety and effectiveness of TET compared with conventional open thyroidectomy (COT) in papillary thyroid cancer (PTC). Method Medical literature databases such as PubMed, Embase, the Cochrane Library, and Web of science were systematically searched for articles that compared TET and COT in PTC treatment from database inception until March 2019. The quality of the studies included in the review was evaluated using the Downs and Black scale using Review Manager software Stata V.13.0 for the meta-analysis. Results The systematic review and meta-analysis were based on 5664 cases selected from twenty publications. Criteria used to determine surgical completeness included postoperative thyroglobulin (TG) levels, recurrence of the tumor after long-term follow-up. Adverse event and complication rate scores included transient recurrent laryngeal nerve (RLN) palsy, permanent RLN palsy, transient hypocalcaemia, permanent hypocalcaemia, operative time, number of removed lymph nodes, length of hospital stay and patient cosmetic satisfaction. TET was found to be generally equivalent to COT in terms of surgical completeness and adverse event rate, although TET resulted in lower levels of transient hypocalcemia (OR 1.66; p < 0.05), a smaller number of the retrieved lymph nodes (WMD 0.46; p < 0.05), and better cosmetic satisfaction (WMD 1.73; p < 0.05). COT was associated with a shorter operation time (WMD - 50.28; p < 0.05) and lower rates of transient RLN palsy (OR 0.41; p < 0.05). Conclusions The results show that in terms of safety and efficacy, TET was similar to COT for the treatment of thyroid cancer. Indeed, the tumor recurrence rates and the level of surgical completeness in TET are similar to those obtained for COT. TET was associated with significantly lower levels of transient hypocalcemia and better cosmetic satisfaction, and thus is the better option for patients with cosmetic concerns. Overall, randomized clinical trials and studies with larger patient cohorts and long-term follow-up data are required to further demonstrate the value of the TET.