Luca Canali MD, Marika D. Russell MD, Anthea Sistovaris MD, Amr H. Abdelhamid Ahmed MBBCH, MMSc, Michael Otremba MD, Hien T. Tierney MD, Frédéric Triponez MD, Fares Benmiloud MD, Giuseppe Spriano MD, Giuseppe Mercante MD, Gregory W. Randolph MD, FACS, FACE
{"title":"在保留甲状旁腺功能的全甲状腺切除术中，基于相机的近红外自动荧光与肉眼识别：随机临床试验的系统回顾和荟萃分析。","authors":"Luca Canali MD, Marika D. Russell MD, Anthea Sistovaris MD, Amr H. Abdelhamid Ahmed MBBCH, MMSc, Michael Otremba MD, Hien T. Tierney MD, Frédéric Triponez MD, Fares Benmiloud MD, Giuseppe Spriano MD, Giuseppe Mercante MD, Gregory W. Randolph MD, FACS, FACE","doi":"10.1002/hed.27900","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Hypocalcemia is the most common postoperative complication of total thyroidectomy. Near-infrared autofluorescence (NIRAF) technology is a surgical adjunct that has been increasingly utilized with the aim of preventing postoperative hypocalcemia, but its clinical benefits have not yet been firmly established. The aim of this study was to assess the clinical benefit of utilizing NIRAF technology in patients undergoing total thyroidectomy.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A systematic review and meta-analysis of randomized clinical trials was performed according to PRISMA guidelines.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Seven randomized clinical trials with 1437 patients (318 males, 22.13%) undergoing total thyroidectomy were included for analysis. Risk of postoperative hypocalcemia was reduced in the NIRAF arm (RR, 0.65; 95%CI, 0.50–0.84). Use of NIRAF was also associated with a reduction in the risk of permanent parathyroid dysfunction (RR, 0.46; 95%CI, 0.22–0.95) and inadvertent parathyroid gland resection (RR, 0.40; 95%CI, 0.26–0.60).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>We present a systematic review and meta-analysis of randomized clinical trials examining the impact of NIRAF technology on preservation of parathyroid function. Our results suggest that use of camera-based NIRAF technology reduces the risk of postoperative hypocalcemia, permanent parathyroid dysfunction, and inadvertent parathyroid gland resection.</p>\n </section>\n </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 1","pages":"225-234"},"PeriodicalIF":2.3000,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Camera-based near-infrared autofluorescence versus visual identification in total thyroidectomy for parathyroid function preservation: Systematic review and meta-analysis of randomized clinical trials\",\"authors\":\"Luca Canali MD, Marika D. Russell MD, Anthea Sistovaris MD, Amr H. Abdelhamid Ahmed MBBCH, MMSc, Michael Otremba MD, Hien T. Tierney MD, Frédéric Triponez MD, Fares Benmiloud MD, Giuseppe Spriano MD, Giuseppe Mercante MD, Gregory W. Randolph MD, FACS, FACE\",\"doi\":\"10.1002/hed.27900\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Hypocalcemia is the most common postoperative complication of total thyroidectomy. Near-infrared autofluorescence (NIRAF) technology is a surgical adjunct that has been increasingly utilized with the aim of preventing postoperative hypocalcemia, but its clinical benefits have not yet been firmly established. The aim of this study was to assess the clinical benefit of utilizing NIRAF technology in patients undergoing total thyroidectomy.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A systematic review and meta-analysis of randomized clinical trials was performed according to PRISMA guidelines.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Seven randomized clinical trials with 1437 patients (318 males, 22.13%) undergoing total thyroidectomy were included for analysis. Risk of postoperative hypocalcemia was reduced in the NIRAF arm (RR, 0.65; 95%CI, 0.50–0.84). Use of NIRAF was also associated with a reduction in the risk of permanent parathyroid dysfunction (RR, 0.46; 95%CI, 0.22–0.95) and inadvertent parathyroid gland resection (RR, 0.40; 95%CI, 0.26–0.60).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>We present a systematic review and meta-analysis of randomized clinical trials examining the impact of NIRAF technology on preservation of parathyroid function. Our results suggest that use of camera-based NIRAF technology reduces the risk of postoperative hypocalcemia, permanent parathyroid dysfunction, and inadvertent parathyroid gland resection.</p>\\n </section>\\n </div>\",\"PeriodicalId\":55072,\"journal\":{\"name\":\"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck\",\"volume\":\"47 1\",\"pages\":\"225-234\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-08-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hed.27900\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hed.27900","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
Camera-based near-infrared autofluorescence versus visual identification in total thyroidectomy for parathyroid function preservation: Systematic review and meta-analysis of randomized clinical trials
Background
Hypocalcemia is the most common postoperative complication of total thyroidectomy. Near-infrared autofluorescence (NIRAF) technology is a surgical adjunct that has been increasingly utilized with the aim of preventing postoperative hypocalcemia, but its clinical benefits have not yet been firmly established. The aim of this study was to assess the clinical benefit of utilizing NIRAF technology in patients undergoing total thyroidectomy.
Methods
A systematic review and meta-analysis of randomized clinical trials was performed according to PRISMA guidelines.
Results
Seven randomized clinical trials with 1437 patients (318 males, 22.13%) undergoing total thyroidectomy were included for analysis. Risk of postoperative hypocalcemia was reduced in the NIRAF arm (RR, 0.65; 95%CI, 0.50–0.84). Use of NIRAF was also associated with a reduction in the risk of permanent parathyroid dysfunction (RR, 0.46; 95%CI, 0.22–0.95) and inadvertent parathyroid gland resection (RR, 0.40; 95%CI, 0.26–0.60).
Conclusions
We present a systematic review and meta-analysis of randomized clinical trials examining the impact of NIRAF technology on preservation of parathyroid function. Our results suggest that use of camera-based NIRAF technology reduces the risk of postoperative hypocalcemia, permanent parathyroid dysfunction, and inadvertent parathyroid gland resection.
期刊介绍：
Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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