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Systematic comparison of cervical and extra-cervical surgical approaches for endoscopic thyroidectomy

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Abstract

Objective

To evaluate the clinical application of different surgical approaches for endoscopic thyroidectomy and provide more rational treatment criteria.

Methods

Collect all randomized controlled trials, multi-center studies, clinical controlled trials, clinical trials and other comparative studies of endoscopic thyroidectomy with a large sample size in different databases through an established search strategy, make a systematic analysis of all the included literature.

Results

This study selected 12 publications for analysis from more than 800 articles: these included six publications describing cervical thyroidectomy (A) and six publications describing extra-cervical thyroidectomy (B). Conversion to open surgery occurred in 29 patients in group A and only 4 in group B (p < 0.001). The patients in group A experienced shorter hospital stays than patients in group B (1.90 ± 0.80 vs. 4.03 ± 0.99 days, p < 0.001), and there was shorter operating time in group A (p < 0.001). Hemorrhage occurred in 3 cases in group A and 8 cases in group B (p = 0.04), Seroma occurred in 25 cases in group B but in no cases in group A (p < 0.001). Postoperative cosmetic results evaluated by verbal response scales (VRS) registered showed: group A (3.35 ± 0.60) and group B (3.74 ± 0.50; p < 0.001). Other complications such as recurrent laryngeal nerve injury and hypocalcemia showed no significant differences.

Conclusions

Evaluation of the different surgical approaches for endoscopic thyroidectomy shows that the incidence of hemorrhage and seroma are higher in the extra-cervical group, but the rate of conversion to conventional open surgery is significantly higher in the cervical group. Furthermore, patients who undergo extra-cervical endoscopic thyroidectomy are associated with longer operating time and hospital stays; however, these studies suggest that the extra-cervical surgical approach for endoscopic thyroidectomy is preferable for dealing with more kinds of thyroid tumor and leaving no scars on neck.

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Author information

Authors and Affiliations

  1. Department of General Surgery, The Second Affiliated Hospital of Shantou Medical College, Shantou, People’s Republic of China

    Chen Geng-Zhen & Han Hui

  2. Department of Pediatric Surgery, The Second Affiliated Hospital of Shantou Medical College, Shantou, People’s Republic of China

    Zhang Xuan

  3. Department of Cardiology, Taizhou Hospital of Zhejiang Province (Luqiao Branch), Taizhou, People’s Republic of China

    Shi Wei-Lin

  4. Department of Orthopedic, The Second Affiliated Hospital of Shantou Medical College, Shantou, People’s Republic of China

    Zhuang Ze-Rui

  5. Emergency Department, Taizhou Hospital of Zhejiang Province (Luqiao Branch), Taizhou, People’s Republic of China

    Chen Xi

Authors
  1. Chen Geng-Zhen
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  2. Zhang Xuan
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  3. Shi Wei-Lin
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  4. Zhuang Ze-Rui
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  5. Chen Xi
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  6. Han Hui
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Corresponding author

Correspondence to Han Hui.

Additional information

C. Geng-Zhen and Z. Xuan contributed equally to this work.

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Geng-Zhen, C., Xuan, Z., Wei-Lin, S. et al. Systematic comparison of cervical and extra-cervical surgical approaches for endoscopic thyroidectomy. Surg Today 42, 835–841 (2012). https://doi.org/10.1007/s00595-011-0100-x

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  • DOI: https://doi.org/10.1007/s00595-011-0100-x

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