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Systematic review and meta-analysis of remote-access thyroidectomy versus open thyroidectomy in thyroid cancer patientsRemote surgery offers short-term quality of life boosts for thyroid cancer patients

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Key Takeaway
Note that remote-access thyroidectomy offers short-term quality-of-life advantages over open surgery that often dissipate long term.

This systematic review and meta-analysis examined remote-access thyroidectomy (RAT) compared with open thyroidectomy (OT) in patients with thyroid cancer. The quantitative synthesis included 29 records and assessed health-related quality of life (HRQoL) along with pain, cosmetic satisfaction, swallowing function, and voice outcomes. Follow-up assessments occurred at 1 month, 3 months, 1-2 weeks, 6 months, and long term.

RAT demonstrated early advantages in comprehensive quality of life at 1 month and 3 months, but these benefits dissipated long term. Pain scores were lower on postoperative day 1 for RAT but were paradoxically higher during the 1-2 week period before converging. Cosmetic satisfaction and swallowing function consistently favored RAT over OT. No discernible differences were found for voice outcomes.

The authors note that benefits are heterogeneous and not consistently maintained across all domains or timepoints. Evidence on patient-reported outcomes remains scarce and inconsistent. Funding or conflicts were not reported. The practice relevance suggests RAT may offer selected short- to medium-term patient-reported advantages, particularly in cosmetic satisfaction and swallowing function, though long-term equivalence should be considered.

People with thyroid cancer often face a tough choice between open surgery and newer remote-access techniques. A large review of 29 medical records compared these two approaches to see how they affect daily life. The goal was simple: did the remote method make patients feel better sooner? The answer is yes, but only for a while.

At one month and three months after surgery, those who had the remote-access procedure reported higher quality of life scores. They also felt less pain on the first day and were more satisfied with their cosmetic results. Swallowing function was better too. However, these advantages did not last. By the long term, patients in both groups felt the same.

The data on pain was mixed. While remote surgery hurt less immediately, pain scores were actually higher during the first two weeks before catching up to the open method. Voice outcomes showed no difference between the two groups. The researchers note that these benefits are not consistent across every single measure or every single person. Evidence on what patients feel remains limited and sometimes unclear.

This review suggests remote-access surgery offers selected short-term advantages, especially for how patients look and swallow. It is not a magic cure, but it does provide a different experience for those who choose it early in their recovery.

What this means for you:
Remote surgery helps patients feel better and swallow easier for a few months, but long-term results match open surgery.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
As remote-access thyroidectomy (RAT) becomes more widely used, evidence on patient- reported outcomes, particularly health-related quality of life (HRQoL), remains scarce and inconsistent. This meta-analysis compared postoperative HRQoL between thyroid cancer (TC) patients undergoing RAT and open thyroidectomy (OT) and assessed changes over time. A comprehensive search of five major databases was conducted from inception to August 2025. Studies reporting HRQoL after RAT or OT were included. Outcomes were grouped by postoperative timepoints. Outcomes were stratified across distinct postoperative timepoints to calculate pooled standardized mean difference (SMD) or mean difference (MD). Heterogeneity was explored through rigorous subgroup analyses encompassing surgical modalities, countries, and assessment instruments. Forty-one studies met the inclusion criteria, and 29 records were included in the quantitative synthesis. RAT demonstrated early advantages in comprehensive quality of life at 1 month and 3 months, and these advantages dissipated long term. Pain trajectories exhibited a biphasic pattern: RAT was associated with lower pain scores on postoperative day 1 but paradoxically higher scores during the 1-2 week period, with subsequent convergence. Cosmetic satisfaction and swallowing function consistently favored RAT from 1-2 weeks through 6 months, while voice outcomes showed no discernible differences. RAT appears to confer selected short- to medium-term patient-reported advantages over OT, particularly in cosmetic satisfaction and swallowing function. But these benefits are heterogeneous and not consistently maintained across all domains or timepoints. Future studies should standardize cross-culturally validated PRO instruments and adopt harmonized follow-up intervals and reporting guidelines to clarify the patient-centered value of RAT.
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