Polednak Anthony P
Retired, Connecticut Tumor Registry, Connecticut Department of Public Health, Hartford, Connecticut.
Clin Anat. 2017 Apr;30(3):318-321. doi: 10.1002/ca.22851. Epub 2017 Mar 9.
Systematic reviews (SRs) of anatomical studies may include a meta-analysis (MA) that provides weighted averages as pooled estimates of prevalence. The relationship of the recurrent laryngeal nerve (RLN) to the inferior thyroid artery (ITA) or its branches has been assessed in two published SRs, one without MA of 32 studies (SR1) and the other with MA of 79 studies (SR2). Both SRs reported differences in RLN-ITA patterns (in three categories) by side of the body, but the anterior pattern was less frequent in SR1 vs. SR2. The aim of this review was to explain the differences. The unweighted data from SR1 were found to be more affected (vs. SR2) by a single study with the largest number of RLNs and a low proportion anterior. In a MA using data from SR1, the pooled prevalence estimate for the anterior pattern was substantial (35%) on the right side (vs. 15% on the left) and close to the findings published in SR2. These consistent findings should be relevant to surgeons in attempting to avoid iatrogenic injury to RLNs. Comparison of methods and results from two or more SRs on the same anatomical relationships may be useful in evidence-based anatomy. Clin. Anat. 30:318-321, 2017. © 2017 Wiley Periodicals, Inc.
解剖学研究的系统评价（SRs）可能包括荟萃分析（MA），该分析提供加权平均值作为患病率的汇总估计。已在两项已发表的SRs中评估了喉返神经（RLN）与甲状腺下动脉（ITA）或其分支的关系，一项是对32项研究进行的无MA的SR（SR1），另一项是对79项研究进行的有MA的SR（SR2）。两项SRs均报告了RLN-ITA模式（分为三类）在身体两侧的差异，但与SR2相比，SR1中前侧模式的出现频率较低。本综述的目的是解释这些差异。发现SR1的未加权数据（与SR2相比）受一项RLN数量最多且前侧比例较低的单一研究影响更大。在使用SR1数据的MA中，右侧前侧模式的汇总患病率估计值相当高（35%）（左侧为15%），且接近SR2中发表的结果。这些一致的发现对于外科医生试图避免医源性RLN损伤应具有参考价值。对同一解剖关系的两个或多个SRs的方法和结果进行比较可能有助于基于证据的解剖学研究。临床解剖学。2017年第30卷：318 - 321页。© 2017威利期刊公司。
