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Robotic thyroidectomy versus conventional open thyroidectomy for differentiated thyroid cancer: meta-analysis

Published online by Cambridge University Press:  25 May 2015

Y-C Wang
Affiliation:
Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
K Liu
Affiliation:
Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
J-J Xiong
Affiliation:
Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, China
J-Q Zhu*
Affiliation:
Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu, China
*
Address for correspondence: Dr Jingqiang Zhu, Department of Thyroid and Breast Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China Fax: +86-28-85423822 E-mail: jingqiangzhu@163.com

Abstract

Objective:

To conduct a meta-analysis to compare the short-term outcomes of robotic thyroidectomy and conventional open thyroidectomy for differentiated thyroid cancer.

Methods:

Medline, Embase, Science Citation Index Expanded and the Cochrane Library databases were searched for relevant literature. The evaluated endpoints were intra-operative and post-operative outcomes.

Results:

Twelve eligible, non-randomised comparative studies involving 2513 patients were included, with 923 patients in the robotic thyroidectomy group and 1590 patients in the conventional open thyroidectomy group. Meta-analysis results revealed that robotic thyroidectomy was associated with significantly longer operative time and a lower number of retrieved central lymph nodes, as compared with conventional open thyroidectomy. No significant differences were found between robotic thyroidectomy and conventional open thyroidectomy in terms of post-operative outcomes.

Conclusion:

Robotic thyroidectomy appears to be a feasible and safe surgical procedure for patients with differentiated thyroid cancer. However, more high-quality randomised clinical trials should be undertaken to confirm these findings.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Yang, Y, Gu, X, Wang, X, Xiang, J, Chen, Z. Endoscopic thyroidectomy for differentiated thyroid cancer. Scientific World Journal 2012;2012:456807CrossRefGoogle ScholarPubMed
2Davies, L, Welch, HG. Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 2006;295:2164–7CrossRefGoogle ScholarPubMed
3Jeryong, K, Jinsun, L, Hyegyong, K, Eilsung, C, Jiyoung, S, Insang, S et al. Total endoscopic thyroidectomy with bilateral breast areola and ipsilateral axillary (BBIA) approach. World J Surg 2008;32:2488–93CrossRefGoogle ScholarPubMed
4Bae, JS, Cho, YU, Sung, GY, Oh, SJ, Jung, EJ, Lee, JB et al. The current status of endoscopic thyroidectomy in Korea. Surg Laparosc Endosc Percutan Tech 2008;18:231–5CrossRefGoogle ScholarPubMed
5Kang, SW, Jeong, JJ, Yun, JS, Sung, TY, Lee, SC, Lee, YS et al. Gasless endoscopic thyroidectomy using trans-axillary approach; surgical outcome of 581 patients. Endocr J 2009;56:361–9CrossRefGoogle ScholarPubMed
6Fan, LJ, Jiang, J. Present and future of robot-assisted endoscopic thyroid surgery. Chin Med J (Engl) 2012;125:926–31Google ScholarPubMed
7Tae, K, Ji, YB, Jeong, JH, Lee, SH, Jeong, MA, Park, CW. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach: our early experiences. Surg Endosc 2011;25:221–8CrossRefGoogle ScholarPubMed
8Ikeda, Y, Takami, H, Sasaki, Y, Takayama, J, Niimi, M, Kan, S. Comparative study of thyroidectomies: endoscopic surgery versus conventional open surgery. Surg Endosc 2002;16:1741–5CrossRefGoogle ScholarPubMed
9Lee, KE, Rao, J, Youn, YK. Endoscopic thyroidectomy with the da Vinci robot system using the bilateral axillary breast approach (BABA) technique; our initial experience. Surg Laparosc Endosc Percutan Tech 2009;19:e715CrossRefGoogle Scholar
10Kandil, EH, Noureldine, SI, Yao, L, Slakey, DP. Robotic transaxillary thyroidectomy: an examination of the first one hundred cases. J Am Coll Surg 2012;214:558–64CrossRefGoogle ScholarPubMed
11Kang, SW, Lee, SC, Lee, SH, Lee, KY, Jeong, JJ, Lee, YS et al. Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 2009;146:1048–55CrossRefGoogle Scholar
12Lee, KE, Kim, E, Koo do, H, Choi, JY, Kim, KH, Youn, YK. Robotic thyroidectomy by bilateral axillo-breast approach: review of 1,026 cases and surgical completeness. Surg Endosc 2013;27:2955–62CrossRefGoogle Scholar
13Kang, SW, Jeong, JJ, Yun, JS, Sung, TY, Lee, SC, Lee, YS et al. Robot-assisted endoscopic surgery for thyroid cancer: experience with the first 100 patients. Surg Endosc 2009;23:2399–406CrossRefGoogle ScholarPubMed
14Lee, S, Lee, CR, Lee, SC, Park, S, Kim, HY, Son, H et al. Surgical completeness of robotic thyroidectomy: a prospective comparison with conventional open thyroidectomy in papillary thyroid carcinoma patients. Surg Endosc 2014;28:1068–75CrossRefGoogle ScholarPubMed
15Lang, BH, Wong, CK, Tsang, JS, Wong, KP, Wan, KY. A systematic review and meta-analysis comparing surgically-related complications between robotic-assisted thyroidectomy and conventional open thyroidectomy. Ann Surg Oncol 2013;21:850–61CrossRefGoogle ScholarPubMed
16Jackson, NR, Yao, L, Tufano, RP, Kandil, EH. Safety of robotic thyroidectomy approaches: meta-analysis and systematic review. Head Neck 2014;36:137–43CrossRefGoogle ScholarPubMed
17Sun, GH, Peress, L, Pynnonen, MA. Systematic review and meta-analysis of robotic vs conventional thyroidectomy approaches for thyroid disease. Otolaryngol Head Neck Surg 2014;150:520–32CrossRefGoogle ScholarPubMed
18Kim, BS, Kang, KH, Kang, H, Park, SJ. Central neck dissection using a bilateral axillo-breast approach for robotic thyroidectomy: comparison with conventional open procedure after propensity score matching. Surg Laparosc Endosc Percutan Tech 2014;24:6772CrossRefGoogle ScholarPubMed
19Lee, J, Kwon, IS, Bae, EH, Chung, WY. Comparative analysis of oncological outcomes and quality of life after robotic versus conventional open thyroidectomy with modified radical neck dissection in patients with papillary thyroid carcinoma and lateral neck node metastases. J Clin Endocrinol Metab 2013;98:2701–8CrossRefGoogle ScholarPubMed
20Noureldine, SI, Jackson, NR, Tufano, RP, Kandil, E. A comparative North American experience of robotic thyroidectomy in a thyroid cancer population. Langenbecks Arch Surg 2013;398:1069–74CrossRefGoogle Scholar
21Stang, A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 2010;25:603–5CrossRefGoogle ScholarPubMed
22Athanasiou, T, Al-Ruzzeh, S, Kumar, P, Crossman, MC, Amrani, M, Pepper, JR et al. Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients. Ann Thorac Surg 2004;77:745–53CrossRefGoogle ScholarPubMed
23Higgins, JP, Thompson, SG, Deeks, JJ, Altman, DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60CrossRefGoogle ScholarPubMed
24Lee, J, Yun, JH, Nam, KH, Choi, UJ, Chung, WY, Soh, EY. Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study. Surg Endosc 2011;25:906–12CrossRefGoogle ScholarPubMed
25Lee, KE, Koo do, H, Kim, SJ, Lee, J, Park, KS, Oh, SK et al. Outcomes of 109 patients with papillary thyroid carcinoma who underwent robotic total thyroidectomy with central node dissection via the bilateral axillo-breast approach. Surgery 2010;148:1207–13CrossRefGoogle ScholarPubMed
26Son, H, Park, S, Lee, CR, Lee, S, Kim, JW, Kang, SW et al. Factors contributing to surgical outcomes of transaxillary robotic thyroidectomy for papillary thyroid carcinoma. Surg Endosc 2014;28:3134–42CrossRefGoogle ScholarPubMed
27Kim, JA, Kim, JS, Chang, MS, Yoo, YK, Kim, DK. Influence of carbon dioxide insufflation of the neck on intraocular pressure during robot-assisted endoscopic thyroidectomy: a comparison with open thyroidectomy. Surg Endosc 2013;27:1587–93CrossRefGoogle ScholarPubMed
28Aliyev, S, Taskin, HE, Agcaoglu, O, Aksoy, E, Milas, M, Siperstein, A et al. Robotic transaxillary total thyroidectomy through a single axillary incision. Surgery 2013;153:705–10CrossRefGoogle ScholarPubMed
29Lee, J, Na, KY, Kim, RM, Oh, Y, Lee, JH, Lee, J et al. Postoperative functional voice changes after conventional open or robotic thyroidectomy: a prospective trial. Ann Surg Oncol 2012;19:2963–70CrossRefGoogle ScholarPubMed
30Landry, CS, Grubbs, EG, Warneke, CL, Ormond, M, Chua, C, Lee, JE et al. Robot-assisted transaxillary thyroid surgery in the United States: is it comparable to open thyroid lobectomy? Ann Surg Oncol 2012;19:1269–74CrossRefGoogle ScholarPubMed
31Park, JH, Lee, CR, Park, S, Jeong, JS, Kang, SW, Jeong, JJ et al. Initial experience with robotic gasless transaxillary thyroidectomy for the management of Graves disease: comparison of conventional open versus robotic thyroidectomy. Surg Laparosc Endosc Percutan Tech 2013;23:e173–7CrossRefGoogle ScholarPubMed
32Ji, YB, Song, CM, Bang, HS, Lee, SH, Park, YS, Tae, K. Long-term cosmetic outcomes after robotic/endoscopic thyroidectomy by a gasless unilateral axillo-breast or axillary approach. J Laparoendosc Adv Surg Tech A 2014;24:248–53CrossRefGoogle ScholarPubMed
33Foley, CS, Agcaoglu, O, Siperstein, AE, Berber, E. Robotic transaxillary endocrine surgery: a comparison with conventional open technique. Surg Endosc 2012;26:2259–66CrossRefGoogle ScholarPubMed
34Kim, BS, Kang, KH, Park, SJ. Robotic modified radical neck dissection by bilateral axillary breast approach for papillary thyroid carcinoma with lateral neck metastasis. Head Neck 2015;37:3745Google Scholar
35Tae, K, Song, CM, Ji, YB, Kim, KR, Kim, JY, Choi, YY. Comparison of surgical completeness between robotic total thyroidectomy versus open thyroidectomy. Laryngoscope 2014;124:1042–7CrossRefGoogle ScholarPubMed
36Tae, K, Ji, YB, Cho, SH, Lee, SH, Kim, DS, Kim, TW. Early surgical outcomes of robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach for papillary thyroid carcinoma: 2 years’ experience. Head Neck 2012;34:617–25CrossRefGoogle ScholarPubMed
37Kang, SW, Lee, SH, Park, JH, Jeong, JS, Park, S, Lee, CR et al. A comparative study of the surgical outcomes of robotic and conventional open modified radical neck dissection for papillary thyroid carcinoma with lateral neck node metastasis. Surg Endosc 2012;26:3251–7CrossRefGoogle ScholarPubMed
38Lee, S, Ryu, HR, Park, JH, Kim, KH, Kang, SW, Jeong, JJ et al. Early surgical outcomes comparison between robotic and conventional open thyroid surgery for papillary thyroid microcarcinoma. Surgery 2012;151:724–30CrossRefGoogle ScholarPubMed
39Lee, J, Nah, KY, Kim, RM, Ahn, YH, Soh, EY, Chung, WY. Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy. Surg Endosc 2010;24:3186–94CrossRefGoogle ScholarPubMed
40Kim, WW, Kim, JS, Hur, SM, Kim, SH, Lee, SK, Choi, JH et al. Is robotic surgery superior to endoscopic and open surgeries in thyroid cancer? World J Surg 2011;35:779–84CrossRefGoogle ScholarPubMed
41Yi, O, Yoon, JH, Lee, YM, Sung, TY, Chung, KW, Kim, TY et al. Technical and oncologic safety of robotic thyroid surgery. Ann Surg Oncol 2013;20:1927–33CrossRefGoogle ScholarPubMed
42Ryu, HR, Lee, J, Park, JH, Kang, SW, Jeong, JJ, Hong, JY et al. A comparison of postoperative pain after conventional open thyroidectomy and transaxillary single-incision robotic thyroidectomy: a prospective study. Ann Surg Oncol 2013;20:2279–84CrossRefGoogle ScholarPubMed
43Lee, KE, Koo do, H, Im, HJ, Park, SK, Choi, JY, Paeng, JC et al. Surgical completeness of bilateral axillo-breast approach robotic thyroidectomy: comparison with conventional open thyroidectomy after propensity score matching. Surgery 2011;150:1266–74CrossRefGoogle ScholarPubMed
44Perrier, ND. Why I have abandoned robot-assisted transaxillary thyroid surgery. Surgery 2012;152:1025–6CrossRefGoogle ScholarPubMed
45Miyano, G, Lobe, TE, Wright, SK. Bilateral transaxillary endoscopic total thyroidectomy. J Pediatr Surg 2008;43:299303CrossRefGoogle ScholarPubMed
46Lee, J, Lee, JH, Nah, KY, Soh, EY, Chung, WY. Comparison of endoscopic and robotic thyroidectomy. Ann Surg Oncol 2011;18:1439–46CrossRefGoogle ScholarPubMed
47Kang, SW, Lee, SH, Ryu, HR, Lee, KY, Jeong, JJ, Nam, KH et al. Initial experience with robot-assisted modified radical neck dissection for the management of thyroid carcinoma with lateral neck node metastasis. Surgery 2010;148:1214–21CrossRefGoogle ScholarPubMed