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儿童行甲状舌管囊肿切除术的复发风险:系统评价。

Risk of recurrence in children operated for thyroglossal duct cysts: A systematic review.

机构信息

Department of Otorhinolaryngology, University of Milano-Bicocca, Monza, Italy.

出版信息

J Pediatr Surg. 2013 Jan;48(1):222-7. doi: 10.1016/j.jpedsurg.2012.10.060.

Abstract

PURPOSE

To determine the rate of recurrence following surgical treatment of thyroglossal duct cysts (TDGCs) in children.

METHODS

A search of electronic databases (Pubmed and MEDLINE) was performed in order to identify studies concerning surgical treatment of TGDCs in children published between 1980 and 2012. The following terms were used: "thyroglossal duct cysts", "recurrent", "recurrence", "children", "pediatric".

RESULTS

Sixteen articles were selected with the majority published during the last decade. The total number of included subjects was 1233. The mean (95% confidence interval (CI)) rate of recurrences was 10.7% (9.1%-12.6%). Eleven studies involving 751 subjects reported the frequency of recurrences separately for primary cases. The mean (95% CI) rate of recurrences was 10.8% (8.7%-13.3%). Five studies reported separately results of surgery for secondary cases. The mean (95% CI) rate of recurrences was 20.0% (12.2%-30.8%). Eight of the sixteen studies reported data on risk factors for recurrence. The use of the Sistrunk technique is a protective factor, whereas children who experienced repeated episodes of infection prior to surgery are exposed to a higher risk of recurrence.

CONCLUSION

Recurrences after surgery for TDGCs remain a clinically relevant issue. One of ten operated children experiences a recurrence. Available data support the use of the Sistrunk technique but further studies aimed at improving the clinical management of TDGCs are required.

摘要

目的

确定儿童甲状舌管囊肿(TDGC)手术后的复发率。

方法

通过电子数据库(Pubmed 和 MEDLINE)进行检索,以确定 1980 年至 2012 年间发表的关于儿童 TGDC 手术治疗的研究。使用了以下术语:“thyroglossal duct cysts”、“recurrent”、“recurrence”、“children”、“pediatric”。

结果

选择了 16 篇文章,其中大部分发表于过去十年。纳入的研究对象总数为 1233 人。复发率的平均值(95%置信区间(CI))为 10.7%(9.1%-12.6%)。11 项涉及 751 例患者的研究分别报告了原发性病例的复发频率。复发率的平均值(95% CI)为 10.8%(8.7%-13.3%)。5 项研究分别报告了继发性病例手术的结果。复发率的平均值(95% CI)为 20.0%(12.2%-30.8%)。16 项研究中有 8 项报告了复发的危险因素数据。使用 Sistrunk 技术是一种保护因素,而在手术前经历过多次感染发作的儿童复发的风险更高。

结论

儿童甲状舌管囊肿手术后的复发仍然是一个具有临床意义的问题。每 10 个接受手术的儿童中就有 1 个会复发。现有数据支持使用 Sistrunk 技术,但需要进一步的研究来改善 TDGC 的临床管理。

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