Minimally invasive video-assisted versus conventional open thyroidectomy on immune response: a meta analysis.
OBJECTIVE
The aim of this study was to compare the immune response between the minimally invasive video-assisted thyroidectomy (MIVAT) and conventional thyroidectomy (CT).


METHODS
An exhaustive literature search was performed in the Medline, Embase, and Cochrane Library to identify the randomized controlled trials comparing the immune response between MIVAT and CT. Relevant data were extracted and statistical analysis was done using RevMan 5.0.


RESULTS
Twelve trials including 389 patients were identified. Immune-competent cells demonstrated no significant differences between MIVAT and CT. The including trails were assessed various perioperative plasma cytokine concentrations with no significant differences in interleukin-6 (IL-6), T lymphocytes (CD4(+), CD8(+), CD4/CD8) and NK cells between the MIVAT and CT. However, meta-analysis showed lower counts on postoperative days at 72 h was showed lower C-reactive protein (CRP) level compared to the preoperation levels but showed no significant difference within 24 h in MIVAT S group compared with CT group. Tumor necrosis factor alpha (TNF-α) level after surgery within 24 h and 72 h showed lower TNF-α level after MIVAT surgery within 24 h and 72 h.


CONCLUSIONS
This meta-analysis demonstrates that, MIVAT has less immune response outcomes and that it is a more ideal choice for the patients relative to the conventional surgery.
Department of Comprehensive Surgery, South Building, Chinese PLA General Hospital Beijing 100853, China ; Department of Chinese PLA General Logistics, No. 2 Clinic, Management Support Bureau Beijing 100071, China.
Chenhong
C
Zheng
Department of Orthopedics, 253th Hospital of Chinese PLA #111 Aimin Road, Huhhot 010050, China.
Shouying
S
Liu
Cancer Center, Chinese PLA General Hospital & Chinese PLA Medical School No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
Peiliang
P
Geng
Department of Chinese PLA General Logistics, No. 2 Clinic, Management Support Bureau Beijing 100071, China.
Huiming
H
Zhang
Department of Comprehensive Surgery, South Building, Chinese PLA General Hospital Beijing 100853, China.
Hongpeng
H
Zhang
Department of Comprehensive Surgery, South Building, Chinese PLA General Hospital Beijing 100853, China.
Airong
A
Tang
Department of Comprehensive Surgery, South Building, Chinese PLA General Hospital Beijing 100853, China.
Xiaohua
X
Xie
Minimally invasive video-assisted thyroidectomy; conventional thyroidectomy; immune response