Conversion rates in robotic thyroid surgery: A systematic review and meta‐analysis
Barbara Martino, Letizia Nitro, Loredana De Pasquale, Paolo Lozza, Alberto Maccari, Luca Castellani, Matilde Piazzoni, Matteo Cardellicchio, Antonio Mario Bulfamante, Carlotta Pipolo, Giovanni Felisati, Alberto Maria Saibene
Abstract
OBJECTIVE: To define the conversion risk to open procedure during robot-assisted thyroid surgery (RATS) identifying potential specific subclasses of procedures or accesses at higher conversion risk. METHODS: In a PRISMA-compliant framework, all original prospective studies providing RATS conversion rates from multiple databases were pooled in a random-effects meta-analysis. Conversion rates were compared between different typologies of thyroid surgery and robotic access. RESULTS: 13 studies were deemed eligible. Four conversions from two studies were reported out of 398 procedures. No significant heterogeneity was observed (Cochran's Q p = 0.932; I2 = 0%). The pooled conversion rate was 1% (95% confidence interval, 0.1%-2%). The ANOVA-Q test failed to show significant differences when comparing type of thyroid surgery or robotic access (respectively p = 0.766 and p = 0.457). CONCLUSION: While the conversion rate appears consistently low across studies, prospective data collection and systematic reporting of procedural complications are required for framing high-risk procedures and accesses.