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Meta‐analysis of video‐assisted thyroidectomy versus conventional thyroidectomy
Author(s) -
Zhang Shengchu,
Zheng Yihu,
Wu Binbin,
Zhou Feng,
Zhang Qiyu
Publication year - 2013
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12016
Subject(s) - medicine , thyroidectomy , hypoparathyroidism , recurrent laryngeal nerve , surgery , palsy , adverse effect , blood loss , randomized controlled trial , anesthesia , postoperative pain , pain control , thyroid , alternative medicine , pathology
Aim The purpose of this study was to test the hypothesis that video‐assisted thyroidectomy ( VAT ) affords comparable safety and efficacy compared to open conventional thyroidectomy ( CT ). Patients and Methods Randomized, controlled trials comparing VAT with CT were ascertained by a methodical search using the MEDLINE , P ubmed, O vid, E mbase and C ochrane L ibrary electronic databases. Primary meta‐analysis outcomes were operative time, intraoperative blood loss and complications, including transient recurrent laryngeal nerve palsy ( TRP ), transient hypoparathyroidism ( TH ), permanent recurrent laryngeal nerve palsy ( PRP ), permanent hypoparathyroidism ( PH ) and wound infection ( WI ). The secondary outcomes were postoperative pain within 12, 24 and 48 h after the operation, length of hospital stay and cosmetic result. Results Operative time was significantly less with CT than with VAT , while VAT was associated with better cosmetic result and less pain at 24 h, postoperatively. Blood loss, TRP , TH , PRP , PH , WI and postoperative pain at 48 h did not reach significance between procedures. Comparisons between two procedures concerning postoperative pain within 12 h and length of hospital stay depicted statistically‐significant differences in favour of VAT, but only in the fixed‐effects model. Conclusions VAT is a safe procedure that produces outcomes; in view of short‐term adverse events, similar to CT , it needs a longer operative time and produces better cosmetic results and less postoperative pain in the early phase.