江春容 1李振华 2张卫卫 2杨松 2候悦 2黄荷芳2
作者信息
- 1. 华中科技大学同济医学院附属协和洪湖医院 洪湖市人民医院耳鼻喉头颈外科,湖北 洪湖,433205
- 2. 华中科技大学同济医学院附属协和洪湖医院 洪湖市人民医院甲乳外科
- 折叠
摘要
Abstract
Objective:To systematically evaluate the clinical efficacy of endoscopic thyroidectomy for thyroid carcinoma in the gasless axillary approach by meta-analysis.Methods:A systematic search was conducted for relevant literatures in PubMed,Embase,Wanfang,VIP,CNKI,CBM and other databases.All databases were searched to collect the clinical controlled trials articles on endoscopic thyroidectomy in the gasless axillary approach and conventional open thyroidectomy for thyroid carcinoma from Jan.2020 to Aug.2023.Two independent investigators performed literature screening,data extraction and quality evaluation according to the inclusion and exclu-sion criteria.Meta-analysis was performed on the outcome indicators using RevMan 5.3 software.Results:A total of 16 relevant articles involving 1 863 patients were included,containing 6 articles of randomized controlled trials and 10 articles of retrospective clinical controlled trials.The meta-analysis showed that compared with conventional open thyroidectomy,the rate of postoperative complications in endoscopic thyroidectomy via the gasless axillary approach was less[OR=0.41,95%CI(0.30,0.55),P<0.00001],and the rate of incision cosmetic satisfaction[OR=3.94,95%CI(2.75,5.63),P<0.00001],the operation time[MD=47.23,95%CI(39.61,54.85),P<0.00001],the postoperative drainage volume[MD=56.22,95%CI(42.46,69.98),P<0.00001],the postoperative drainage tube placement time[MD=0.53,95%CI(0.05,1.01),P=0.03],the postoperative hospital stay[MD=0.95,95%CI(0.58,1.32),P<0.00001]and the hospitalization expenses[MD=2169.70,95%CI(1786.01,2553.38),P<0.00001]of endoscopic thyroidectomy group were more,the differences were statistically significant.However,there were no significant differences between the two groups in the intraoperative blood loss and the number of lymph nodes removed(P>0.05).Conclusions:Endoscopic thyroidectomyinthegasless axillary approach and conventional open thyroidectomy are both safe and feasible in the treatment of thyroid carcinoma.Endoscopic thyroidectomy in the gasless axillary approach has advantages in the postoperative complications and incision cosmetic satisfaction.关键词
甲状腺肿瘤/甲状腺切除术/内窥镜检查/经腋窝入路/无充气/Meta分析Key words
Thyroid neoplasms/Thyroidectomy/Endoscopy/Axillary approach/Gasless/Meta-analysis分类
医药卫生
