Photo Credit: Nemes Laszlo

The following is a summary of “Feasibility of remote-access and minimally invasive video-assisted approaches in lateral neck dissection for papillary thyroid carcinoma: A systematic review and network meta-analysis,” published in the June 2024 issue of Surgery by Nguyen et al.

This study evaluates the feasibility and surgical outcomes of minimally invasive video-assisted thyroidectomy (MIVAT) and three remote-access approaches—robotic bilateral axillo-breast approach (BABA-R), endoscopic breast-chest approach (BCA-E), and robotic gasless transaxillary approach (GTAA-R)—for lateral neck dissection in papillary thyroid carcinoma, compared with the conventional transcervical approach (CTA).

From January 2000 to February 2024, a systematic review and network meta-analysis were conducted using PubMed, EMBASE, and Cochrane Library databases. The study compares surgical feasibility, safety, and oncologic outcomes across these approaches.

After rigorous screening, fourteen articles were included. The number of removed and metastatic lateral lymph nodes, the extent of dissection, rates of transient recurrent laryngeal nerve palsy and hypoparathyroidism, serum-stimulated thyroglobulin levels, and recurrence rates did not significantly differ between MIVAT, BABA-R, BCA-E, GTAA-R, and CTA. Operative times were longer for MIVAT and remote-access techniques, but they consistently offered superior cosmetic outcomes compared to CTA.

Lateral neck dissection using MIVAT and remote-access approaches is feasible, with outcomes comparable to CTA regarding lymph node retrieval, complication rates, thyroglobulin levels, and recurrence. While these techniques require longer operative times, they provide significantly enhanced cosmetic results compared to traditional approaches.

Source: sciencedirect.com/science/article/abs/pii/S0748798324005213