title: Robotic Thyroidectomy Versus Nonrobotic Approaches: A Meta-Analysis Examining Surgical Outcomes.
abstract: Background Robotic surgery has been recently used as a novel tool for remote access thyroid surgery. We performed a meta-analysis of the current literature to examine the safety and oncological efficacy of robotic surgery compared to endoscopic and conventional approaches for different thyroid procedures. Methods A systematic search of the online data bases was done using the following (MeSH) terms "robotic surgery," "robotic thyroidectomy," "robot-assisted thyroidectomy," and "robot-assisted thyroid surgery." Outcomes measured included total operative time, length of hospital stay, postoperative thyroglobulin levels, and postoperative complications. Statistical differences were analyzed between groups through the standard means and/or relative risk by using STATA analytical software. Results In this study, 144 articles were identified; of which 18 of them met our inclusion criteria, totaling 4878 patients. Robotic approach was associated with longer total operative time (mean difference of 43.5 minutes) when compared to the conventional cervical approach (95% CI = 20.9-66.2; P < .001). Robotic approach was also found to have a similar risk of total postoperative complications when compared to the conventional and endoscopic approaches. Conclusion Robotic thyroid surgery is as safe, feasible and provides similar periperative complications and oncological outcomes when compared to both, conventional cervical and endoscopic approaches. However, robotic thyroid surgery is associated with longer operative time when compared to the conventional open approach.
authors.affiliation: Tulane University School of Medicine, New Orleans, LA, USA ekandil@tulane.edu.
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
authors.affiliation: Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: AbdulRahman Y
authors.initials: AY
authors.lastname: Hammad
authors.affiliation: Louisiana State University Health Science Center, New Orleans, LA, USA.
authors.forename: Rohan R
authors.initials: RR
authors.lastname: Walvekar
authors.affiliation: Tulane University School of Public Health, New Orleans, LA, USA.
authors.forename: Tian
authors.initials: T
authors.lastname: Hu
authors.affiliation: Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Hammad
authors.initials: H
authors.lastname: Masoodi
authors.affiliation: Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Salah Eldin
authors.initials: SE
authors.lastname: Mohamed
authors.affiliation: Tulane University School of Medicine, New Orleans, LA, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Deniwar
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Stack
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: endoscopic surgery; robotic surgery; robotic thyroidectomy; surgical outcomes; thyroid surgery