Abstract
Aim: This systematic review and meta-analysis evaluates surgical outcome and safety results of conventional (OT) versus endoscopic transaxillary gasless thyroidectomies (ET).Material and methods: A systematic literature search was performed.The weighted mean differences or the odd ratios with corresponding 95% CIs were examined for surgical outcomes and complications.The results were analysed using fixed-or random-effects models.The heterogeneity was checked by the Cochran Q test and the extent of inconsistency was evaluated by the I 2 statistic.Results: Ten studies and 1597 patients were included.All studies found that ET required longer operative time.Postoperative pain was significantly lower after ET on day 1 and day 7.No statistical difference was found in complication rates.Conclusions: ET has disadvantages such as longer surgery time, but it is a feasible and safe procedure with lower postoperative pain and comparable complication rates to OT.However, good quality prospective randomised studies are necessary to draw firmer conclusions.