title: Safety of robotic thyroidectomy approaches: meta-analysis and systematic review.
abstract: BACKGROUND
  This study compared the efficacy of robotic thyroidectomy via a gasless, axillary approach with conventional cervical and endoscopic techniques by meta-analysis.
  
  
  METHODS
  Articles were identified from the following keyword searches: robotic/robot-assisted thyroidectomy/thyroid surgery. Outcomes included operative time, hospital stay, complications, and cosmetic satisfaction after surgery. Between-group outcome differences were calculated using random-effects models.
  
  
  RESULTS
  In all, 87 publications were identified and 9 studies met inclusion criteria, totaling 2881 patients, 1122 of whom underwent robotic thyroidectomy. Those who underwent robotic surgery reported greater cosmetic satisfaction, with a pooled net mean difference of -1.35 (95% confidence interval [CI]: -1.69, -1.09). Robotic approach operative time was longer than that of the conventional approach (95% CI: 29.23, 54.87), with a trend to be shorter than the endoscopic approaches. Robotic surgery had similar risks to open and endoscopic approaches.
  
  
  CONCLUSIONS
  Our meta-analysis suggests that robotic thyroidectomy is as safe, feasible, and efficacious as conventional cervical and endoscopic thyroidectomy, showing superior cosmetic satisfaction than that of conventional thyroidectomy.
authors.affiliation: Department of Surgery, Division of Endocrine and Oncological Surgery, Tulane University School of Medicine, New Orleans, Louisiana; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
authors.forename: Nicole R
authors.initials: NR
authors.lastname: Jackson
authors.forename: Lu
authors.initials: L
authors.lastname: Yao
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
authors.forename: Emad H
authors.initials: EH
authors.lastname: Kandil
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D061214:Patient Safety; D016032:Randomized Controlled Trials as Topic; D012371:Robotics / Q000379:methods*; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: meta-analysis; minimally invasive; robotic; thyroidectomy; transaxillary