Frontiers in endocrinology · 2026
Prevalence and determinants of recurrent laryngeal nerve injury after thyroidectomy: a Systematic Review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Awawda Rifat, Merchavy Shlomo, Elhadi Uday Abd, Safia Alaa
Аннотация
BACKGROUND: Recurrent laryngeal nerve injury (RLNI) is a major complication of thyroid surgery and may lead to voice impairment and reduced quality-of-life.
AIM: This systematic review and meta-analysis sought to determine the frequency of temporary/permanent RLNI after different types of thyroid operations and to identify surgical and patient-related factors that influence risk.
METHODS: PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar were searched in July 17, 2024. Eligible studies reported original data on RLNI after any type or approach of thyroidectomy in ≥20 patients. Risk of bias using RoB-2 for randomized trials and the Newcastle-Ottawa Scale for observational studies was done. Random-effects meta-analyses were performed. Subgroup and meta-regression analyses explored the effects of surgical type, method, approach, intraoperative nerve monitoring (IONM), hemostasis, drain use, and patient age on RLNI risk.
RESULTS: A total of 199 studies (304,352 patients) were analyzed. Transient RLNI was most frequent after completion thyroidectomy (10%, 95%CI, 4-16%) and hemithyroidectomy (8%, 95%CI, 1-15%), and least after near-total thyroidectomy (2%, 95%CI, 1-3%). Transoral and transcervical approaches had the highest transient RLNI rates (5%, 95%CI, 3-6%), while transaxillary had the lowest (1%, 95%CI, 1-2%). Permanent RLNI was highest in secondary thyroidectomy (2%, 95%CI, 1-3%). Meta-regression identified surgical approach, IONM use, hemostasis method, drain use, and patient age as significant determinant.
CONCLUSIONS: Completion and revision surgeries, along with certain surgical approaches, increase RLNI risk. Tailoring surgical technique and optimizing intraoperative strategies are essential to minimize nerve injury.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42024556259.
AIM: This systematic review and meta-analysis sought to determine the frequency of temporary/permanent RLNI after different types of thyroid operations and to identify surgical and patient-related factors that influence risk.
METHODS: PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar were searched in July 17, 2024. Eligible studies reported original data on RLNI after any type or approach of thyroidectomy in ≥20 patients. Risk of bias using RoB-2 for randomized trials and the Newcastle-Ottawa Scale for observational studies was done. Random-effects meta-analyses were performed. Subgroup and meta-regression analyses explored the effects of surgical type, method, approach, intraoperative nerve monitoring (IONM), hemostasis, drain use, and patient age on RLNI risk.
RESULTS: A total of 199 studies (304,352 patients) were analyzed. Transient RLNI was most frequent after completion thyroidectomy (10%, 95%CI, 4-16%) and hemithyroidectomy (8%, 95%CI, 1-15%), and least after near-total thyroidectomy (2%, 95%CI, 1-3%). Transoral and transcervical approaches had the highest transient RLNI rates (5%, 95%CI, 3-6%), while transaxillary had the lowest (1%, 95%CI, 1-2%). Permanent RLNI was highest in secondary thyroidectomy (2%, 95%CI, 1-3%). Meta-regression identified surgical approach, IONM use, hemostasis method, drain use, and patient age as significant determinant.
CONCLUSIONS: Completion and revision surgeries, along with certain surgical approaches, increase RLNI risk. Tailoring surgical technique and optimizing intraoperative strategies are essential to minimize nerve injury.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42024556259.