| 薛世航,曾熘海,陈敏芝,等.经口腔前庭联合颏下入路与经口腔前庭入路腔镜甲状腺切除治疗甲状腺癌的Meta分析[J].肿瘤学杂志,2025,31(7):627-632. |
| 经口腔前庭联合颏下入路与经口腔前庭入路腔镜甲状腺切除治疗甲状腺癌的Meta分析 |
| Meta Analysis of Transoral Endoscopic Thyroidectomy Vestibular and Submental Approach versus Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Cancer |
| 投稿时间：2025-01-08 |
| DOI：10.11735/j.issn.1671-170X.2025.07.B009 |
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| 中文关键词: 甲状腺肿瘤 经口腔前庭入路 颏下 腔镜 Meta分析 |
| 英文关键词:thyroid neoplasms transoral vestibular approach submental endoscopy Meta-analysis |
| 基金项目:浙江省医药卫生科技计划（2023XY165） |
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| 中文摘要: |
| 摘 要：［目的］评价经口腔前庭联合颏下入路腔镜甲状腺切除术（transoral endoscopic thyroidectomy vestibular and submental approach，TOETVSA）与经口腔前庭入路腔镜甲状腺切除术（transoral endoscopic thyroidectomy vestibular approach，TOETVA）治疗甲状腺乳头状癌（papillary thyroid carcinoma，PTC）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例患者，其中TOETVSA组187例，TOETVA组221例。与TOETVA相比，TOETVSA手术时间更短［标准化均值差（standard mean difference，SMD）= -1.30，95%置信区间（confidence interval，CI）：-2.16~-0.44，P=0.003］、颌下或下唇麻木发生率更低［比值比（odds ratio，OR）= 0.19，95% CI：0.08~0.45，P<0.001］，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均无统计学意义（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: |
| Abstract：［Objective］ To 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 TOETVSA and TOETVA for PTC treatment between January 2015 and December 2024 were retrieved from databases China National Knowledge Infrastructure (CNKI)， Wanfang， Embase， Cochrane Library， and PubMed. Following strict inclusion and exclusion criteria， the data in the included literature were extracted. Meta-analysis was performed using R software (version 4.3.2). ［Results］ Five studies involving 408 patients were included， with 187 in the TOETVSA group and 221 in the TOETVA group. Compared to TOETVA， TOETVSA demonstrated a shorter operation time ［standardized mean difference (SMD)=-1.30， 95% confidence interval(CI)： -2.16~ -0.44， P=0.003］ and a lower incidence of submental or lower lip numbness［odds ratio (OR)=0.19， 95%CI：0.08~0.45， P<0.001］. No significant difference was observed between the two groups in the number of central lymph nodes dissected， intraoperative blood loss， postoperative drainage volume， or recurrent laryngeal nerve injury (P>0.05). ［Conclusion］ TOETVSA optimizes the surgical approach， shortens operation time， and reduces postoperative discomfort， offering a feasible and aesthetically favorable option for PTC patients while achieving surgical goals. |
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