Endoscopy-assisted lateral neck dissection trumps conventional open procedures

Aside from a longer operation time, endoscopic-assisted lateral neck dissection (EALND) provides comparable efficacy and safety as conventional open lateral neck dissection (COLND) and results in a more aesthetically pleasing incision and quicker postoperative recovery, a recent meta-analysis has found.

Drawing from the online databases of PubMed, Embase, the Cochrane Library, WanFang, VIP, and CNKI, the researchers retrieved seven studies. The cumulative cohort consisted of 372 patients, of whom 157 underwent EALND and 215 were treated with COLND. Only one included study was a randomized controlled trial, while the rest were retrospective in design.

Pooled analysis of three studies revealed that EALND led to significantly longer operative times relative to COLND (mean difference [MD], 24.86, 95 percent confidence interval [CI], 21.76–27.96; p<0.05).

In contrast, EALND held the advantage over COLND in terms of other outcome measures, such as length of scar (MD, –8.14, 95 percent CI, –8.41 to –7.88; p<0.00001), length of stay (MD, –1.45, 95 percent CI, –2.70 to –0.21; p=0.02), and the incidence of neck discomfort (odds ratio, 0.19, 95 percent CI, 0.07–0.58; p=0.003).

Moreover, three studies looked at the postoperative cosmetic outcomes and found that EALND likewise outperformed COLND.

“The results of this meta-analysis showed that the length of hospitalization for the EALND group was shorter than for the COLND group,” the researchers said. “This may be due to the small surgical incision and reduced trauma in EALND, so this result suggests that the use of the EALND procedure can improve the utilization of public health care resources.’

Nevertheless, the obtained estimates were highly heterogeneous, which none of the sensitivity analyses could substantially reduce. Future studies are needed to confirm these findings.