Transaxillary gasless endoscopic thyroidectomy versus conventional open thyroidectomy: systematic review and...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Endocrine Surgery

Background:

• Conventional open thyroidectomy (OT) is a standard surgical approach.
• Endoscopic transaxillary gasless thyroidectomy (ET) is an alternative minimally invasive technique.
• Comparative data on surgical outcomes and safety between OT and ET are limited.

Purpose of the Study:

• To systematically review and meta-analyze surgical outcomes and safety of conventional open thyroidectomy (OT) versus endoscopic transaxillary gasless thyroidectomy (ET).

Main Methods:

• Systematic literature search conducted.
• Weighted mean differences and odds ratios with 95% CIs analyzed for outcomes and complications.
• Fixed- or random-effects models used for analysis.
• Heterogeneity assessed using Cochran Q test and I² statistic.

Main Results:

• Ten studies involving 1597 patients were included.
• Endoscopic transaxillary gasless thyroidectomy (ET) was associated with significantly longer operative times.
• Postoperative pain was significantly lower on day 1 and day 7 after ET.
• No significant difference in complication rates between ET and OT was observed.

Conclusions:

• Endoscopic transaxillary gasless thyroidectomy (ET) is a feasible and safe procedure with the advantage of reduced postoperative pain compared to open thyroidectomy (OT).
• Longer operative time is a disadvantage of ET.
• Further high-quality prospective randomized studies are needed for definitive conclusions.