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Systematic Review and Meta-Analysis of Transaxillary Robotic Thyroidectomy Versus Open Thyroidectomy

Shen, Hongliang MD, PhD*; Shan, Chengxiang MD; Qiu, Ming MD, PhD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: June 2014 - Volume 24 - Issue 3 - p 199–206
doi: 10.1097/SLE.0b013e3182a47a40
Review Articles

Purpose: It remains controversial whether the transaxillary robotic thyroidectomy (RT) is a feasible or better alternative to open thyroidectomy (OT) in thyroid surgery. We aimed to evaluate the efficacy of RT by pooling comparative studies of RT and OT in a systematic review and meta-analysis.

Materials and Methods: Original articles comparing transaxillary RT and conventional OT for thyroid diseases, published in the English language from1990 until February 3, 2013 were systematically searched in PubMed, Embase, Medline, and the Cochrane Library. The outcomes analyzed were postoperative complications, number of retrieved lymph nodes, operative time, postoperative hospital stay, and cosmetic satisfaction.

Results: Nine studies that fulfilled the eligibility criteria were included in the meta-analysis, of a total of 1615 patients (510 RT and 1105 OT). Compared with OT, RT showed a similar incidence of complications, number of retrieved lymph nodes, and length of postoperative hospital stay. The cosmetic effect of RT was superior to OT. But the operative time of RT was significantly longer than OT.

Conclusions: The available data suggest that the efficacy of RT is similar to OT in the treatment of thyroid diseases on the whole. RT has a better cosmetic effect than OT. But longer operative time is needed by RT.

Departments of *Surgery

General Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China

The authors declare no conflicts of interest.

Reprints: Ming Qiu, MD, PhD, Department of General Surgery, Changzheng Hospital, the Second Military Medical University, 415 Fengyang Road, Shanghai 200003, China (e-mail:

Received May 14, 2013

Accepted June 10, 2013

© 2014 by Lippincott Williams & Wilkins