Minimally Invasive Remote Approaches Versus Conventional Open Approach in Central Neck Dissection for Patients Undergoing Total Thyroidectomy: A Systematic Review and Meta-Analysis.
Minimally invasive central neck dissection takes longer than open surgery for thyroid cancer
Minimally Invasive Remote Approaches Versus Conventional Open Approach in Central Neck Dissection for Patients Undergoing Total Thyroidectomy: A Systematic Review and Meta-Analysis.
Total thyroidectomy (thyroidectomy) with central neck dissection (central neck dissection) is the standard surgical approach in selected thyroid cancer patients.
To compare minimally invasive remote approaches and the conventional open approach (conventional open approach) for central neck dissection during thyroidectomy in terms of surgical outcomes, postoperative complications, and oncologic adequacy.
Following PRISMA 2020 guidelines, a systematic review and meta-analysis was conducted.
minimally invasive central neck dissection took substantially longer than open surgery
No significant differences were observed between the two techniques in terms of transient vocal fold paralysis (OR 1.38; 95% CI 0.93-2.04) or transient hypoparathyroidism (OR 0.83; 95% CI 0.46-1.49).
Intraoperative blood loss, postoperative drainage volume, and length of hospital stay were comparable between groups.
The number of retrieved lymph nodes was slightly lower in the minimally invasive remote approaches group, although the effect size was small (SMD -0.12; 95% CI -0.26 to -0.003).
Due to limited and inconsistent reporting, permanent vocal fold paralysis and permanent hypoparathyroidism could not be quantitatively analyzed.
Minimally invasive remote approaches for central neck dissection during thyroidectomy appears to be feasible and safe in carefully selected thyroid cancer patients, with postoperative complication rates comparable to those of the conventional open approach.
However, given the longer operative times and the limited evidence on long-term oncologic outcomes, the conventional open approach should remain the reference standard, while minimally invasive remote approaches may be considered in selected patients at specialized high-volume centers.