Abstract：
Laryngoceles are best treated with surgery. The goal of this study is to compare patient outcomes and complications in patients undergoing removal of laryngoceles with either transoral endoscopic/microlaryngoscopic or robotic approaches. A systematic review of the published literature was conducted using Pubmed, Web of Science, and the Cochrane Clinical Trials databases. A pooled analysis of individual data was used to compare outcomes between robotic and endoscopic approaches. A total of 30 studies were included. Nine studies with 95 patients were included in the final analysis. Eighty-one (85.26%) were treated with microlaryngoscopic surgery and 14 (14.74%) were treated with robotic-assisted surgery. The rates of tracheostomy (RR = 1.44, 95% CI = 0.389-5.332), complications (RR = 0.329, 95% CI = 0.047-2.294) and recurrence (RR = 0.354, 95% CI = 0.021-5.897) were not statistically different between groups. Within the endoscopic subgroup, 66 laryngoceles (78.57%) were completely excised, while 18 (21.43%) laryngoceles were treated with marsupialization. Marsupialization was associated with an increased risk of recurrence (RR = 4.889, 95% CI = 1.202-19.891). In the robotic subgroup, there was an increased risk of nasogastric tube use (RR = 103.867, 95% CI = 6.379-1619.214) and a longer mean length of hospital stay (p = 0.0001). Transoral treatment of laryngoceles has complication and recurrence rates of 18.95% and 7.37%, respectively. Robotic approaches are associated with higher rates of NGT use and increased hospital stay, however much of this is due to one robotic surgeon\'s preference for routine NGT placement and higher rates of combined laryngocele removal via robotic approach. Complete excision of combined laryngoceles is possible with transoral approaches. Marsupialization, reported in traditional endoscopic approaches, is associated with a significantly higher rate of recurrence (22.22% vs. 4.76%).
摘要：
喉癌最好用手术治疗。这项研究的目的是比较经口内窥镜/显微喉镜或机器人方法切除喉囊的患者的预后和并发症。使用Pubmed，WebofScience,和Cochrane临床试验数据库.个体数据的汇总分析用于比较机器人和内窥镜方法之间的结果。共纳入30项研究。最终分析中纳入了9项研究，其中95名患者。81例（85.26％）采用显微喉镜手术治疗，14例（14.74％）采用机器人辅助手术治疗。气管切开率（RR=1.44，95%CI=0.389-5.332），并发症(RR=0.329,95%CI=0.047-2.294)和复发(RR=0.354,95%CI=0.021-5.897)组间无统计学差异.在内窥镜亚组中，完全切除66例喉囊肿（78.57％），而18例（21.43%）喉膨出用袋气治疗。袋袋化与复发风险增加相关(RR=4.889,95%CI=1.202-19.891)。在机器人子组中，使用鼻胃管的风险增加(RR=103.867,95%CI=6.379~1619.214),平均住院时间延长(p=0.0001).经口治疗喉塞的并发症和复发率分别为18.95%和7.37%,分别。机器人方法与更高的NGT使用率和住院时间增加有关。然而,这在很大程度上是由于一名机器人外科医生倾向于常规NGT放置,以及通过机器人方法清除合并喉癌的比率更高.经口入路可以完全切除合并的喉癌。有袋化,在传统的内窥镜方法中报道，与显著较高的复发率相关(22.22%vs.4.76%）。
