Rao Karthik N, Rajguru Renu, Dange Prajwal, Vetter Diana, Triponez Frederic, Nixon Iain J, Randolph Gregory W, Mäkitie Antti A, Zafereo Mark, Ferlito Alfio
Department of Head and Neck Oncology, All India Institute of Medical Sciences, Raipur 492099, India.
Sri Shankara Cancer Hospital and Research Center, Bangalore 560004, India.
Diagnostics (Basel). 2024 Feb 27;14(5):505. doi: 10.3390/diagnostics14050505.
Iatrogenic injury of the parathyroid glands is the most frequent complication after total thyroidectomy.
To determine the effectiveness of near-infrared autofluorescence (NIRAF) in reducing postoperative hypocalcemia following total thyroidectomy.
PubMed, Scopus, and Google Scholar databases were searched. Randomised trials reporting at least one hypocalcemia outcome following total thyroidectomy using NIRAF were included.
The qualitative data synthesis comprised 1363 patients from nine randomised studies, NIRAF arm = 636 cases and non-NIRAF arm = 637 cases. There was a statistically significant difference in the overall rate of hypocalcemia log(OR) = -0.7 [(-1.01, -0.40), M-H, REM, CI = 95%] and temporary hypocalcemia log(OR) = -0.8 [(-1.01, -0.59), M-H, REM, CI = 95%] favouring the NIRAF. The difference in the rate of permanent hypocalcemia log(OR) = -1.09 [(-2.34, 0.17), M-H, REM, CI = 95%] between the two arms was lower in the NIRAF arm but was not statistically significant.
NIRAF during total thyroidectomy helps in reducing postoperative hypocalcemia. Level of evidence-1.
甲状旁腺医源性损伤是全甲状腺切除术后最常见的并发症。
确定近红外自发荧光（NIRAF）在降低全甲状腺切除术后低钙血症发生率方面的有效性。
检索了PubMed、Scopus和谷歌学术数据库。纳入了报告使用NIRAF进行全甲状腺切除术后至少一项低钙血症结果的随机试验。
定性数据综合分析纳入了9项随机研究中的1363例患者，NIRAF组 = 636例，非NIRAF组 = 637例。低钙血症总发生率[对数比值比（log(OR)）=-0.7，（-1.01，-0.40），M-H，随机效应模型（REM），95%置信区间（CI）]和暂时性低钙血症发生率[log(OR)=-0.8，（-1.01，-0.59），M-H，REM，CI = 95%]存在统计学显著差异，支持NIRAF组。两组之间永久性低钙血症发生率的差异[log(OR)=-1.09，（-2.34，0.17），M-H，REM，CI = 95%]在NIRAF组较低，但无统计学意义。
全甲状腺切除术中使用NIRAF有助于降低术后低钙血症发生率。证据等级为1级。
