Wei Lu, Qiang Chen, Pei Zhang, Anping Su, Jingqiang Zhu
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引用次数: 5
摘要
目的:本荟萃分析旨在评估近红外自身荧光(NIRAF)成像在甲状腺切除术中对甲状旁腺(PG)的识别和保护中的地位。方法:检索截至2021年6月的PubMed、MEDLINE、EMBASE、Web of Science和Cochrane Library数据库。主要结果是评估采用NIRAF成像与标准裸眼(N-E)手术相比,术后低钙、无意PG切除和PG自体移植的发生率。结果:8项研究,2889例患者纳入分析。我们的分析显示,NIRAF组的短暂性低钙血症发生率为7.11% (60/844),N-E组为22.40% (458/2045)(p p = 0.0008)。NIRAF组和N-E组的PG误切率分别为7.65%(55/719)和14.39%(132/917)。(p)结论:与N-E识别相比,NIRAF成像在甲状腺切除术中的应用有助于降低PG误切的发生率,降低术后低钙血症和甲状旁腺功能低下的风险。
Near-Infrared Autofluorescence Imaging in Thyroid Surgery: A Systematic Review and Meta-Analysis.
Objective: This meta-analysis aimed to assess the position of near-infrared autofluorescence (NIRAF) imaging in the recognition and protection of the parathyroid gland (PG) during thyroidectomy.
Methods: The PubMed, MEDLINE, EMBASE, Web of Science, and Cochrane Library databases were searched up to June 2021. The primary outcome was to evaluate the rates of postoperative hypocalcemia, inadvertent PG resection, and autotransplantation of PG when adopting NIRAF imaging compared with standard naked-eye (N-E) surgery.
Results: Eight studies with 2,889 patients were enrolled in the analysis. Our analysis showed that the incidence of transient hypocalcemia was 7.11% (60/844) in the NIRAF group and 22.40% (458/2045) in the N-E group (p < 0.0001) and the rate of transient hypoparathyroidism was 28.31% (126/445) and 33.36% (496/1487) in the NIRAF and N-E groups (p = 0.0008). The rate of inadvertent resection of PGs was 7.65% (55/719) in the NIRAF group and 14.39% (132/917) in the N-E group (p < 0.0001). No significant difference was observed in other indexes including the pooled proportion of permanent hypocalcemia and rate of PG autotransplantation.
Conclusions: The application of NIRAF imaging in thyroidectomy can help lower the incidence of inadvertent PG resection and reduce the risk of postoperative hypocalcemia and hypoparathyroidism compared with N-E recognition.
期刊介绍:
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.