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| 经口腔前庭联合颏下入路与完全经口腔前庭腔镜甲状腺切除治疗甲状腺癌的Meta分析 |
| Meta-Analysis of Transoral Vestibular Combined with Submental Approach Versus Totally Transoral Vestibular Endoscopic Thyroidectomy for the Treatment of Thyroid Cancer |
| 投稿时间：2025-01-08 修订日期：2025-03-05 |
| DOI： |
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| 中文关键词: 经口腔前庭 颏下 腔镜 甲状腺切除 Meta分析 |
| 英文关键词:Transoral Vestibular Submental Endoscopic Thyroidectomy Meta-analysis |
| 基金项目:浙江省医药卫生科技计划项目(2023XY165) |
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| 中文摘要: |
| 目的：系统评价经口腔前庭联合颏下入路（Transoral Endoscopic Thyroidectomy Vestibular and Submental Approach, TOETVSA）与经口腔前庭腔镜甲状腺切除手术 (Transoral Endoscopic Thyroidectomy Vestibular Approach, TOETVA)在治疗甲状腺乳头状癌（Papillary Thyroid Carcinoma, PTC）中的疗效和安全性。
方法：检索2015年1月至2024年12月在中国知网、万方、Embase、Cochrane Library 和 PubMed数据库发表的关于TOETVSA与TOETVA在治疗PTC疗效和安全性比较的临床研究。遵循严格的纳入和排除标准，筛选文献并提取数据，采用R软件（版本4.3.2）进行Meta分析。
结果：纳入5项研究，共408名患者。与TOETVA相比，TOETVSA手术时间更短[SMD = -1.30, 95%CI: (-2.16, -0.44), P = 0.0029]、颌下或下唇麻木发生概率更低[OR = 0.19, 95% CI: (0.08, 0.45), P = 0.0001]，两组中央区淋巴结清扫数量、出血量、术后引流量、喉返神经损伤比较差异无统计学意义（P ? 0.05）。
结论：TOETVSA优化了手术路径，缩短了手术时间，减轻了术后不适感，在满足手术治疗目标的同时，为患者提供了兼具美观需求的可行方案。 |
| 英文摘要: |
| Objective: To systematically evaluate the efficacy and safety of Transoral Endoscopic Thyroidectomy Vestibular and Submental Approach (TOETVSA) versus Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) in the treatment of Papillary Thyroid Carcinoma (PTC).
Methods: Clinical studies comparing the efficacy and safety of TOETVSA and TOETVA for the treatment of PTC, published between January 2015 and December 2024 in CNKI, Wanfang, Embase, Cochrane Library, and PubMed databases, were retrieved. Studies were selected and data were extracted following strict inclusion and exclusion criteria, and a meta-analysis was conducted using R software (version 4.3.2).
Results: A total of 5 studies involving 408 patients were included. Compared to TOETVA, TOETVSA resulted in shorter operation time [SMD = -1.30, 95% CI: (-2.16, -0.44), P = 0.0029] and a lower incidence of submental or lower lip numbness [OR = 0.19, 95% CI: (0.08, 0.45), P = 0.0001]. No significant differences were found between the two groups in terms of the number of central lymph node dissections, blood loss, postoperative drainage volume, or recurrent laryngeal nerve injury (P < 0.05).
Conclusion: TOETVSA optimizes the surgical approach, shortening the operation time and reducing postoperative discomfort while meeting surgical treatment goals. It also offers a feasible solution that satisfies aesthetic needs for patients. |
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