ABSTRACT
BACKGROUND: Endoscopic thyroidectomy (ET) has been widely accepted as a surgical option for benign thyroid lesions, yet remains controversial in the treatment of malignant thyroid because of concerns with the safety and efficacies. This paper aims at systematically evaluating the advantages and disadvantages of ET in malignant thyroid tumors through meta-analyses. METHODS: Meta-analysis was conducted by retrieving all studies on the treatment of malignant thyroid carcinomas released in database, including PubMed, Web of Science, Cochrane and Google scholar, from January 2005 to January 2019. Then the safety and efficacies were compared between the two surgical modalities based on current reports. RESULTS: Totally, 3,482 cases were included in 11 related studies. Most adverse outcomes by ET were involved in transient or permanent recurrent laryngeal nerve paralysis (RLN) and hypocalcemia, postoperative total complications, hemorrhage, hematoma at the incision, and total relapse rate following surgery. Besides, ET led to higher incidence of transient RLN palsy, yet significantly lower transient hypocalcemia than conventional open thyroidectomy (COT). The difference was insignificant regarding transient or permanent RLN and hypocalcemia, total postoperative complications, postoperative hemorrhage, incisional hematoma and total recurrent rate between the two procedures. Secondary outcomes consisted of operative time, hospital stay and cosmetic results, by which COT was superior to ET, yet cosmetic incision was better by ET than by COT. There was no significant difference in hospital stay. CONCLUSIONS: ET can be feasible and safe surgical option for malignant thyroid lesions, with better cosmetic effect.
ABSTRACT
BACKGROUND: To compare the value of contrast-enhanced ultrasound (CEUS) qualitative and quantitative analysis in the identification of breast tumor lumps. MATERIALS AND METHODS: Qualitative and quantitative indicators of CEUS for 73 cases of breast tumor lumps were retrospectively analyzed by univariate and multivariate approaches. Logistic regression was applied and ROC curves were drawn for evaluation and comparison. RESULTS: The CEUS qualitative indicator-generated regression equation contained three indicators, namely enhanced homogeneity, diameter line expansion and peak intensity grading, which demonstrated prediction accuracy for benign and malignant breast tumor lumps of 91.8%; the quantitative indicator-generated regression equation only contained one indicator, namely the relative peak intensity, and its prediction accuracy was 61.5%. The corresponding areas under the ROC curve for qualitative and quantitative analyses were 91.3% and 75.7%, respectively, which exhibited a statistically significant difference by the Z test (P<0.05). CONCLUSIONS: The ability of CEUS qualitative analysis to identify breast tumor lumps is better than with quantitative analysis.
