手术放大镜对甲状腺切除术后并发症的影响：一项荟萃分析。

Implication of surgical loupes on complications following thyroidectomy: a meta-analysis.

作者信息

Rao Karthik N, Zafereo Mark, Rao Advaith N, Nixon Iain, Robbins K T, Sreeram M P, Rodrigo Juan P, Sanabria Alvaro, Mair Manish, Vander Poorten Vincent, Guntinas-Lichius Orlando, Ronen Ohad, Kowalski Luiz P, Randolph Gregory, Ferlito Alfio

机构信息

Department of Head and Neck Oncology, Sri Shanakara Cancer Hospital and Research Center, Bangalore, India.

Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, TX, 77030, USA.

出版信息

Eur Arch Otorhinolaryngol. 2025 Mar;282(3):1159-1169. doi: 10.1007/s00405-024-09003-2. Epub 2024 Oct 7.

DOI:10.1007/s00405-024-09003-2

PMID:39375200

Abstract

OBJECTIVE

To determine the effectiveness of surgical loupes in reducing postoperative RLN palsy and hypocalcemia following thyroidectomy.

DATA SOURCES

PubMed, Scopus and Google Scholar databases were searched between 2000 and 2024.

REVIEW METHODS

Studies were included if they reported at least one complication outcome following thyroidectomy using surgical loupes. The outcome measure was the log odds ratio, with negative log odds indicating results favouring the experimental group. The model utilized the DerSimonian-Laird estimator, and Wald-type tests.

RESULTS

The qualitative data synthesis included 813 patients from 6 included studies, including 410 patients with surgical loupes and 403 patients without surgical loupes. There was a statistically significant reduction in the rate of temporary RLN palsy in the surgical loupe group log(OR) = - 0.87 [(- 1.58, - 0.15), DL (Dersimonian and Laird method), REM (random effects model), CI (confidence interval) = 95%], or a 41.8% lower probability. The rates of permanent RLN palsy log(OR) = - 0.31 [(- 1.45, 0.82), DL, REM, CI = 95%], temporary hypocalcemia log(OR) = - 0.34 [(- 1.25, 0.57), DL, REM, CI = 95%], and permanent hypocalcemia log(OR) = - 0.85 [(- 2.24, 0.54), DL, REM, CI = 95%] were not statistically significant between the two groups, although there were trends toward decreases in these rates in the loupes group.

CONCLUSIONS

Surgical loupe use during thyroidectomy can lead to a 41.8% lower probability of temporary RLN palsy compared to operating without loupes.

LEVEL OF EVIDENCE

3a.

摘要

目的

确定手术放大镜在降低甲状腺切除术后喉返神经麻痹和低钙血症发生率方面的有效性。

数据来源

检索了2000年至2024年期间的PubMed、Scopus和谷歌学术数据库。

综述方法

纳入的研究需报告使用手术放大镜进行甲状腺切除术后至少一种并发症的结果。结果测量指标为对数比值比，负对数比值表明结果有利于实验组。该模型采用DerSimonian-Laird估计器和Wald型检验。

结果

定性数据综合分析纳入了6项纳入研究中的813例患者，其中410例使用手术放大镜，403例未使用手术放大镜。手术放大镜组的暂时性喉返神经麻痹发生率有统计学显著降低，对数（OR）=-0.87 [（-1.58，-0.15），DL（DerSimonian和Laird方法），REM（随机效应模型），CI（置信区间）=95%]，即概率降低41.8%。两组之间永久性喉返神经麻痹的对数（OR）=-0.31 [（-1.45，0.82），DL，REM，CI=95%]、暂时性低钙血症的对数（OR）=-0.34 [（-1.25，0.57），DL，REM，CI=95%]和永久性低钙血症的对数（OR）=-0.85 [（-2.24，0.54），DL，REM，CI=95%]无统计学显著差异，尽管放大镜组这些发生率有下降趋势。