Cao Hongtai, Han Jixiang, Zhang Donghong, Yu Zeyuan, Wang Mancai, Jiao Zuoyi
Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou 730030; Key Laboratory of Digestive System Tumors of Gansu Province, Lanzhou 730030, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014 Jun;39(6):625-31. doi: 10.11817/j.issn.1672-7347.2014.06.013.
To systematically evaluate the efficiency and safety of total thyroidetomy (including near-total tyhroidectomy) versus subtotal thyroidectomy for multinodular goiter.
The literatures were searched from Cochrane Library, PubMed, Embase, Chinese Biological Medical Datebase, Chinese National Knowledge Infrastructure, and Chinese Science and Technology Journal Full-text Database as of November 2013. We included all randomizad controlled trials on total (including near-total) versus subtotal thyroidectomy in the treatment of multinodular goiter. The collecting of data and quality assessment were respectively completed by 2 researchers. RevMan5.1 software was used for Meta-analysis.
We collected 7 literatures conforming to the standard, incuding 2 192 patients. The Metaanalysis outcomes showed that total thyroidectomy was associated with lower nodule recurrence rate (OR=0.13, 95% CI: 0.07-0.22, P<0.001) and higher in transient hypoparathyroidism rate (OR=2.33, 95% CI: 1.72-3.17, P<0.001). However, no statistical difference was seen comparing total and subtotal thyroidectomy in permanent recurrent laryngeal nerve paralysis rate (OR= 0.81, 95% CI: 0.24-2.74, P=0.74) and permanent hypoparathyroidism rate (OR=2.94, 95% CI: 0.48- 18.11, P=0.24).
Nodule recurrence rate of total thyroidectomy for multinodular goiter is lower than subtotal thyroidectomy and does not increase permanent complications.
系统评价甲状腺全切除术(包括近全切除术)与甲状腺次全切除术治疗结节性甲状腺肿的有效性和安全性。
检索截至2013年11月的Cochrane图书馆、PubMed、Embase、中国生物医学文献数据库、中国知网和维普数据库。纳入所有关于甲状腺全切除术(包括近全切除术)与甲状腺次全切除术治疗结节性甲状腺肿的随机对照试验。由2名研究人员分别完成数据收集和质量评估。采用RevMan5.1软件进行Meta分析。
共收集到7篇符合标准的文献,包括2192例患者。Meta分析结果显示,甲状腺全切除术的结节复发率较低(OR=0.13,95%CI:0.07-0.22,P<0.001),暂时性甲状旁腺功能减退发生率较高(OR=2.33,95%CI:1.72-3.17,P<0.001)。然而,甲状腺全切除术与甲状腺次全切除术在永久性喉返神经麻痹发生率(OR=0.81,95%CI:0.24-2.74,P=0.74)和永久性甲状旁腺功能减退发生率(OR=2.94,95%CI:0.48-18.11,P=0.24)方面无统计学差异。
结节性甲状腺肿行甲状腺全切除术的结节复发率低于甲状腺次全切除术,且不增加永久性并发症。