Postoperative Cosmetic Outcomes and Quality of Life After Thyroidectomy: A Systematic Review and Network Meta-Analysis.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2025-09-30 DOI:10.1002/hed.70052

Van Cuong Nguyen, Chang Myeon Song, Yong Bae Ji, Jin Hyeok Jeong, Jonathon O Russell, Feng-Yu Chiang, Gregory W Randolph, Kyung Tae

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引用次数: 0

Abstract

Background: Remote-access thyroidectomy and minimally invasive video-assisted thyroidectomy (MIVAT) were developed to improve cosmesis over the conventional transcervical approach (CTA). However, comparative data on cosmetic and quality of life (QOL) outcomes remain limited.

Methods: A systematic review and random-effects network meta-analysis was performed to compare MIVAT, five remote-access approaches-breast approach (BA), bilateral axillo-breast approach (BABA), gasless transaxillary approach (GTAA), retroauricular approach (RA), and transoral approach (TOA)-with CTA.

Results: Fifty-seven studies (9206 patients) were included. All remote-access techniques and MIVAT showed superior cosmetic outcomes versus CTA. TOA and BABA ranked highest. Remote-access approaches, particularly TOA, BABA, and GTAA, demonstrated generally better QOL outcomes than CTA and MIVAT.

Conclusions: Remote-access approaches and MIVAT offer superior cosmesis over CTA. TOA and BABA generally rank highest in both cosmesis and QOL, although evidence on QOL remains limited. These approaches may be considered for patients prioritizing aesthetic and psychosocial outcomes.

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甲状腺切除术后美容效果和生活质量：系统回顾和网络荟萃分析。

背景：远程进入甲状腺切除术和微创视频辅助甲状腺切除术（MIVAT）的发展是为了改善传统的经宫颈入路（CTA）的美容。然而，关于美容和生活质量（QOL）结果的比较数据仍然有限。方法：通过系统回顾和随机效应网络meta分析，比较MIVAT、5种远程入路——乳房入路（BA）、双侧腋窝-乳房入路（BABA）、无气经腋窝入路（GTAA）、耳后入路（RA）和经口入路（TOA）与CTA。结果：纳入57项研究（9206例）。与CTA相比，所有远程访问技术和MIVAT均显示出更好的美容效果。TOA和BABA排名最高。远程访问方法，特别是TOA、BABA和GTAA，通常比CTA和MIVAT表现出更好的生活质量。结论：远程入路和MIVAT比CTA有更好的美容效果。尽管关于生活质量的证据仍然有限，但TOA和BABA通常在外观和生活质量方面都排名最高。这些方法可以考虑优先考虑审美和社会心理结果的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

期刊介绍： Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.