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Perioperative Outcomes of Endoscopic versus Open Operation in the Treatment of Hyperparathyroidism: A Systematic Review and Meta-analysis

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机构: [1]Capital Med Univ, Affiliated Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing 100730, Peoples R China [2]Shandong First Med Univ, Affiliated Liaocheng Hosp, Liaocheng Peoples Hosp, Dept Thyroid & Breast Surg, Liaocheng 252000, Shandong, Peoples R China [3]Shandong First Med Univ, Affiliated Liaocheng Hosp, Liaocheng Peoples Hosp, Joint Lab Translat Med Res, Liaocheng 252000, Shandong, Peoples R China
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关键词: Endoscopic Hyperparathyroidism Open operation Meta-analysis Perioperative outcomes

摘要:
Objective: Hyperthyroidism can cause multiple organs damage, which is characterized by diversity and systemic. At present, there are mainly drug treatment and surgical treatment, among which surgical treatment has the highest cure rate. Surgical treatment mainly includes endoscopic and open surgery in clinical. This article systematically reviews previously published trials on the two surgical methods, and provides an updated meta-analysis of the perioperative outcomes of different surgical methods on hyperthyroidism. Methods: We searched 7 online databases home and abroad retrieval time till 3 February, 2021. We studied the influence of endoscopic and open surgery on the perioperative outcome of HPT. Data were processed with RevMan 5.3 and Stata 12.0. The methodological quality assessment of non-randomized clinical trials used risk of bias in non-randomised studies of interventions. The cochrane collaboration's tool for assessing bias risk was used to assess the quality of the included randomized controlled studies. The operation time, intraoperative blood loss, postoperative drainage volume and hospital stay were examined. Two authors exchanged and checked the extraction tables, and resolved any inconsis-tencies by discussing. Results: A total of 4 studies were included, including 124 patients and 246 controls. The combined results of random-effect model: WMD (95% CI)=-12.96 minutes (-43.47, 17.54) , P=0.40. Similarly, intraoperative blood loss, postoperative drainage volume and hospital stay also showed significant heterogeneity (I2>50%), but the combined results were statistically significant. Meta-analysis results of the three indicators (WMD (95%CI)) were as follows:-10.59 (-15.64,-5.54) mL, P<0.001;-11.69 (-19.65,-3.73) mL, P=0.004;-1.02 (-1.88,-0.16) days, P=0.02. In addition to the operation time, intraop-erative blood loss, postoperative drainage volume and hospital stay of the intervention group were significantly lower than the control group. Conclusions: This paper concluded that endoscopic surgery showed certain advantages over open surgery in the treatment of hyperparathyroidism by performed the meta-analysis of clinical studies on the treatment of HPT with EPTX and OPTX, which the finding could provide theoretical guidance for clinical practice.

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第一作者机构: [1]Capital Med Univ, Affiliated Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing 100730, Peoples R China [2]Shandong First Med Univ, Affiliated Liaocheng Hosp, Liaocheng Peoples Hosp, Dept Thyroid & Breast Surg, Liaocheng 252000, Shandong, Peoples R China
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