Safety of robotic thyroidectomy approaches: meta-analysis and systematic review

Head Neck. 2014 Jan;36(1):137-43. doi: 10.1002/hed.23223. Epub 2013 Mar 8.

Abstract

Background: This study compared the efficacy of robotic thyroidectomy via a gasless, axillary approach with conventional cervical and endoscopic techniques by meta-analysis.

Methods: Articles were identified from the following keyword searches: robotic/robot-assisted thyroidectomy/thyroid surgery. Outcomes included operative time, hospital stay, complications, and cosmetic satisfaction after surgery. Between-group outcome differences were calculated using random-effects models.

Results: In all, 87 publications were identified and 9 studies met inclusion criteria, totaling 2881 patients, 1122 of whom underwent robotic thyroidectomy. Those who underwent robotic surgery reported greater cosmetic satisfaction, with a pooled net mean difference of -1.35 (95% confidence interval [CI]: -1.69, -1.09). Robotic approach operative time was longer than that of the conventional approach (95% CI: 29.23, 54.87), with a trend to be shorter than the endoscopic approaches. Robotic surgery had similar risks to open and endoscopic approaches.

Conclusions: Our meta-analysis suggests that robotic thyroidectomy is as safe, feasible, and efficacious as conventional cervical and endoscopic thyroidectomy, showing superior cosmetic satisfaction than that of conventional thyroidectomy.

Keywords: meta-analysis; minimally invasive; robotic; thyroidectomy; transaxillary.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures / methods
  • Patient Safety*
  • Randomized Controlled Trials as Topic
  • Robotics / methods*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / methods*
  • Treatment Outcome