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Meta-Analysis
. 2020 Dec;146(12):3297-3312.
doi: 10.1007/s00432-020-03418-0. Epub 2020 Oct 27.

Robotic surgery versus open surgery for thyroid neoplasms: a systematic review and meta-analysis

Hanghang Liu #  1 , Yue Wang #  2 , Chenzhou Wu  1 , Wei Fei  3 , En Luo  4
Affiliations
Meta-Analysis

Robotic surgery versus open surgery for thyroid neoplasms: a systematic review and meta-analysis

Hanghang Liu et al. J Cancer Res Clin Oncol. 2020 Dec.

Abstract

Purpose: Robotic surgical system has been gradually applied in thyroid neoplasms as a novel treatment for years, with presenting some superiorities as well as limitations. To compare the effectiveness and safety of robotic surgery with open surgery for the patients with thyroid neoplasms, this review was conducted METHODS: We performed electronic search in CENTRAL, MEDLINE, EMBASE, CNKI, CBM, Opengray, and Sciencepaper Online databases and manual search in specific online databases and according to the reference list of relevant papers to get all the studies that compared the effectiveness and safety of robotic surgery with that of open surgery for patients with thyroid neoplasms. Last update was conducted in March 2020. Randomized-controlled trials, case-control studies, cohort studies, and cross-sectional surveys were all included.

Results: In this review, 59 studies were included: two RCTs, 15 NRSs, 40 cohort studies, and two cross-sectional studies. Robotic surgery was found to be associated with longer operative duration, less retrieved lymph nodes, higher postoperative thyroglobulin before radioactive iodine ablation, similar complication incidence but less blood loss, better functional recovery, and higher cosmetic satisfaction compared to open surgery.

Conclusions: Robotic surgery is a safe and feasible approach with remarkable superiority in reducing intraoperative damage and improving patients' quality of life compared to open surgery for thyroid neoplasms. Meanwhile, this procedure is also associated with long operative duration, insufficient removal of neck lymph nodes, which need to be given careful consideration.

Keywords: Open surgery; Robotic surgery; Thyroid neoplasms; Thyroidectomy.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Diagram of article retrieval
Fig. 2
Fig. 2
Forest plot for a Operative duration of total thyroidectomy; b hospitalization; c postoperative drain amount; d intraoperative bleeding; e duration of drainage
Fig. 3
Fig. 3
Forest plot for a transient hypoparathyroidism and hypocalcemia; b other complications
Fig. 4
Fig. 4
Forest plot for a number of retrieved lymph nodes that based on the range of neck dissection; b number of retrieved lymph nodes that based on the robotic surgical approach; c recurrence rate; d Postoperative sTg before RAI; e Postoperative sTg after RAI
Fig. 5
Fig. 5
Forest plot for a postoperative neck paresthesia; b postoperative chest paresthesia; c cosmetic satisfaction
See this image and copyright information in PMC

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