Quality of life after endoscopic vs. conventional open thyroidectomy: a systematic review and meta-analysis
Vishesh Agrawal, Sanjay Kumar Yadav, Pawan Agarwal, Dhananjaya Sharma, Saroj Kanta Mishra
Abstract
BACKGROUND: We have performed a meta-analysis of studies reporting on Health-related quality of life (QoL) after endoscopic thyroidectomy (ETx) vs. open thyroidectomy (OTx). OBJECTIVES: The objective was to evaluate the QoL outcomes of ETx compared to OTx. METHODS: Eligibility criteria: Studies comparing ETx vs OTx INFORMATION SOURCES: PubMed, EMBASE, the Cochrane library, and online registers were searched for articles comparing QoL in ETx vs OTx. RISK OF BIAS: Articles were assessed for risk of bias using Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. SYNTHESIS OF RESULTS: The main summary measures using the random effects model were mean difference (MD). RESULTS: Three studies were included in the meta-analysis. Two studies compared QoL between Transoral Endoscopic Thyroidectomy vs OTx and one compared Transaxillary Endoscopic Thyroidectomy vs OTx. There were no significant differences in the QoL outcomes using SF-36 scale. Pain scores assessed using the visual analogue scale (VAS) and overall satisfaction were also comparable between ETx and OTx. CONCLUSION: Our systematic review and meta-analysis indicate that QoL outcomes for ETx and OTx may be comparable based on the currently available evidence. The substantial heterogeneity across studies and the lack of adequately powered trials limit the generalizability of these findings. Future large-scale randomized controlled trials with robust QoL measures, such as ThyPRO-39, are needed to provide higher-quality evidence on the comparative effectiveness of ETx versus OTx.