title: Systematic review and meta-analysis of transaxillary robotic thyroidectomy versus open thyroidectomy.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Departments of *Surgery †General Surgery, Changzheng Hospital, the Second Military Medical University, Shanghai, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Shen
authors.forename: Chengxiang
authors.initials: C
authors.lastname: Shan
authors.forename: Ming
authors.initials: M
authors.lastname: Qiu
mesh_terms: D001365:Axilla; D006801:Humans; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control; D012371:Robotics / Q000379:methods* / Q000458:organization & administration*; D013959:Thyroid Diseases / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*