PMID- 25236330
OWN - NLM
STAT- MEDLINE
DCOM- 20150325
LR  - 20220318
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 125
IP  - 2
DP  - 2015 Feb
TI  - A systematic review and meta-analysis evaluating completeness and outcomes of 
      robotic thyroidectomy.
PG  - 509-18
LID - 10.1002/lary.24946 [doi]
AB  - OBJECTIVES/HYPOTHESIS: Despite immense interest, robotic-assisted thyroidectomy 
      (RT) remains controversial in differentiated thyroid carcinoma (DTC). This 
      systematic review and meta-analysis compared surgical completeness and/or 
      oncological outcomes between RT and open thyroidectomy (OT) in low-risk DTC. 
      STUDY DESIGN: Systematic review. METHODS: A systematic review was performed to 
      identify studies that compared surgical completeness and/or oncological outcomes 
      between RT and OT in DTC. Any study that compared at least one parameter relating 
      to surgical completeness and/or oncological outcome for DTC was considered. 
      Number of central lymph nodes (CLNs) retrieved during central neck dissection 
      (CND), preablation stimulated thyroglobulin (sTg) level, radioiodine uptake on 
      post-therapy scan, and locoregional recurrence (LRR) were examined. Meta-analysis 
      was performed using a fixed or random-effects model depending on heterogeneity 
      between studies. RESULTS: Ten studies were eligible. Of the 2,205 DTCs, 752 
      (34.1%) had RT, whereas 1,453 (65.9%) had OT. Relative to OT, RT had 
      significantly fewer CLNs retrieved during CND (4.7 +/- 3.2 vs. 5.5 +/- 3.8, 
      standardized mean difference [SMD] = -0.240, 95% confidence interval [CI]: -0.364 
      to -0.116, P < .001) and higher preablation sTg level (3.6 +/- 6.7 ng/mL vs. 
      2.0 +/- 5.0 ng/mL, SMD = 0.272, 95% CI: 0.022 to 0.522, P = .033). Interestingly, 
      these differences were more evident in the robotic transaxillary approach (RTAA) 
      than the robotic bilateral axillo-breast approach. After a mean follow-up of 17.7 
      months, no LRR was found in RT, whereas after 18.6 months, one LRR was found in 
      OT. CONCLUSIONS: Relative to OT, total thyroidectomy by RTAA was associated with 
      fewer CLNs retrieved and less-complete thyroid resection. However, using RTAA is 
      unlikely to compromise the outcomes of low-risk DTC because of its inherently 
      good prognosis.
CI  - (c) 2014 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Lang, Brian Hung-Hin
AU  - Lang BH
AD  - Department of Surgery, University of Hong Kong, Hong Kong, China.
FAU - Wong, Carlos K H
AU  - Wong CK
FAU - Tsang, Julian S
AU  - Tsang JS
FAU - Wong, Kai P
AU  - Wong KP
FAU - Wan, Koon Y
AU  - Wan KY
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20140919
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Humans
MH  - Neoplasm Recurrence, Local
MH  - *Outcome and Process Assessment, Health Care
MH  - *Robotics
MH  - Thyroid Neoplasms/*surgery
MH  - Thyroidectomy/*methods
OTO - NOTNLM
OT  - Robotic thyroidectomy
OT  - central lymph nodes
OT  - papillary thyroid carcinoma
OT  - radioactive iodine
OT  - thyroglobulin
OT  - total thyroidectomy
EDAT- 2014/09/23 06:00
MHDA- 2015/03/26 06:00
CRDT- 2014/09/20 06:00
PHST- 2014/04/24 00:00 [received]
PHST- 2014/08/06 00:00 [revised]
PHST- 2014/09/04 00:00 [accepted]
PHST- 2014/09/20 06:00 [entrez]
PHST- 2014/09/23 06:00 [pubmed]
PHST- 2015/03/26 06:00 [medline]
AID - 10.1002/lary.24946 [doi]
PST - ppublish
SO  - Laryngoscope. 2015 Feb;125(2):509-18. doi: 10.1002/lary.24946. Epub 2014 Sep 19.