title: Total endoscopic versus conventional open thyroidectomy for papillary thyroid microcarcinoma.
abstract: BACKGROUND
  The objective of this study was to conduct a meta-analysis to assess the safety and efficacy of total endoscopic thyroidectomy (TET) versus conventional open thyroidectomy (COT) for papillary thyroid microcarcinoma with regard to short-term clinical outcomes.
  
  
  METHODS
  MEDLINE, EMBASE, Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials in the Cochrane Library between January 1996 and July 2014 were searched to identify relevant comparative studies. Pooled weighted mean differences (WMD) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using either fixed or random-effects models. The perioperative outcomes were evaluated.
  
  
  RESULTS
  Five eligible nonrandomized studies were included, involving 1004 patients: 475 were TET and 529 were COT. Meta-analysis results revealed that TET group had a significantly longer operative time (WMD, 48.15; 95% CI, 27.54-68.75; P < 0.00001), compared with the COT group. While analyzing the number of removed lymph nodes, 4 studies were included. The TET group had a less number of removed lymph nodes (WMD, -0.68; 95% CI, -1.20 to -0.15; P = 0.01). There were no significant differences in terms of hospital stay, transient recurrent laryngeal nerve palsy, permanent recurrent laryngeal nerve palsy, transient hypocalcemia, and permanent hypocalcemia.
  
  
  CONCLUSIONS
  Total endoscopic thyroidectomy appears to be a much feasible safe surgical procedure for papillary thyroid microcarcinoma in selected patients.
authors.affiliation: From the Departments of *Thyroid and Breast Surgery, †Cardiology, and ‡Pancreatic Surgery, West China Hospital, Sichuan University, Guo Xue Rd 37, Chengdu, Sichuan Province, China.
authors.forename: Yichao
authors.initials: Y
authors.lastname: Wang
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.forename: Junjie
authors.initials: J
authors.lastname: Xiong
authors.forename: Jingqiang
authors.initials: J
authors.lastname: Zhu
mesh_terms: D002291:Carcinoma, Papillary / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D007902:Length of Stay; D008197:Lymph Node Excision; D061646:Operative Time; D012449:Safety; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000209:etiology