无充气经腋窝入路传统腔镜与机器人甲状腺切除术疗效的Meta分析OACSTPCD

Objective:To compare the safety and efficacy of traditional gasless transaxillary endoscopic thyroidectomy(ET)and gasless transaxillary robotic thyroidectomy(RT)by meta-analysis.Methods:A retrieval strategy was developed to search Wanfang,China national knowledge infrastructure,Embase,Cochrane Library,and PubMed database for literatures on the two surgical methods.Retrospective clinical controlled studies of ET and RT were screened according to inclusion and exclusion criteria,and the results were compared by meta-analysis.The indicators included operation time,number of lymph node dissection,hospital stay,temporary,temporary recurrent laryngeal nerve injury,postoperative drainage volume.RevMan 5.4 software was used to analyze the data.Results:Five studies with a total of 1 752 patients were included.Compared with ET group,the number of intraoperative lymph node dissection(WMD=-0.55,95%CI=-0.89～-0.20,P=0.002,I2 =54%)and temporary postoperative hypoparathyroidism(OR=0.25,95%CI=0.14～0.43,P<0.00001,I2 =41%)in RT group was more.No permanent hypoparathyroidism occurred in RT group and one case occurred in ET group.There was no permanent recurrent laryngeal nerve injury in either group.There was no significant difference in operation time(WMD=-20.81,95%CI=-41.89～0.27,P=0.05,I2 =95%)and hospital stay(OR=-0.06,95%CI=-0.22～0.11,P=0.50,I2= 45%)between the two groups.Conclusions:The advantage of RT lies in the dissection of central lymph nodes.RT is similar with ET in terms of recurrent laryngeal nerve injury and hospital stay.