Implication of surgical loupes on complications following thyroidectomy: a meta-analysis.
Hypocalcemia
Loupes
Magnification
Recurrent laryngeal nerve
Thyroid gland
Thyroidectomy
Journal
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937
Informations de publication
Date de publication:
07 Oct 2024
07 Oct 2024
Historique:
received:
13
06
2024
accepted:
19
09
2024
medline:
8
10
2024
pubmed:
8
10
2024
entrez:
7
10
2024
Statut:
aheadofprint
Résumé
To determine the effectiveness of surgical loupes in reducing postoperative RLN palsy and hypocalcemia following thyroidectomy. PubMed, Scopus and Google Scholar databases were searched between 2000 and 2024. 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. 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. Surgical loupe use during thyroidectomy can lead to a 41.8% lower probability of temporary RLN palsy compared to operating without loupes. 3a.
Identifiants
pubmed: 39375200
doi: 10.1007/s00405-024-09003-2
pii: 10.1007/s00405-024-09003-2
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Orloff LA, Parangi S (2023) History of thyroid surgery in the last century. Thyroid 33(9):1029–1038
de Herder WW (2014) Heroes in endocrinology: nobel prizes. Endocr Connect 3(3):R94-104
doi: 10.1530/EC-14-0070
Stefanou CK, Papathanakos G, Stefanou SK, Tepelenis K, Kitsouli A, Barbouti A et al (2022) Surgical tips and techniques to avoid complications of thyroid surgery. Innov Surg Sci 7(3–4):115–123
Wilhelm A, Conroy PC, Calthorpe L, Frye W, Sosa JA, Roman S (2023) Routine use of intraoperative nerve monitoring is associated with a reduced risk of vocal cord dysfunction after thyroid cancer surgery. BMC Surg 23(1):215
doi: 10.1186/s12893-023-02122-3
Rao KN, Rajguru R, Dange P, Vetter D, Triponez F, Nixon IJ et al (2024) Lower rates of hypocalcemia following near-infrared autofluorescence use in thyroidectomy: a meta-analysis of RCTs. Diagn Basel Switz 14(5):505
Jain S, Gupta N, Gupta R, Jain A, Naidu TS (2020) Microscopic thyroidectomy: the way we do it. Indian J Otolaryngol Head Neck Surg 72(4):437–442
doi: 10.1007/s12070-020-01853-6
D’Ambra M, Tedesco A, Iacone B, Bracale U, Corcione F, Peltrini R (2023) First application of the Orbeye™ 4K 3D exoscope in recurrent papillary thyroid cancer surgery. J Clin Med 12(7):2492
doi: 10.3390/jcm12072492
Antakia R, Edafe O, Uttley L, Balasubramanian SP (2015) Effectiveness of preventative and other surgical measures on hypocalcemia following bilateral thyroid surgery: a systematic review and meta-analysis. Thyroid Off J Am Thyroid Assoc 25(1):95–106
doi: 10.1089/thy.2014.0101
Nagaty M, Shehata MS, Elkady AS, Eid M, Nady M, Youssef A et al (2023) An assessment of the role of surgical loupe technique in prevention of postthyroidectomy complications: a comparative prospective study. Ann Med Surg 2012 85(3):446–452
doi: 10.1097/MS9.0000000000000271
Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2(349):g7647
doi: 10.1136/bmj.g7647
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J et al (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 21(358):j4008
doi: 10.1136/bmj.j4008
OCEBM Levels of Evidence. [cited 2024 Apr 4]. Available from: https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence
Lo CKL, Mertz D, Loeb M (2014) Newcastle-Ottawa Scale: comparing reviewers’ to authors’ assessments. BMC Med Res Methodol 14(1):45
doi: 10.1186/1471-2288-14-45
Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M et al (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 12(355):i4919
doi: 10.1136/bmj.i4919
Szumilas M (2010) Explaining Odds ratios. J Can Acad Child Adolesc Psychiatry 19(3):227–229
Higgins JPT, Thompson SG, Spiegelhalter DJ (2009) A re-evaluation of random-effects meta-analysis. J R Stat Soc Ser A Stat Soc 172(1):137–159
doi: 10.1111/j.1467-985X.2008.00552.x
Thomson HJ, Thomas S (2013) The effect direction plot: visual display of non-standardised effects across multiple outcome domains. Res Synth Methods 4(1):95–101
doi: 10.1002/jrsm.1060
Song F (1999) Exploring heterogeneity in meta-analysis: is the L’Abbé plot useful? J Clin Epidemiol 52(8):725–730
doi: 10.1016/S0895-4356(99)00066-9
Lin L, Chu H (2018) Quantifying publication bias in meta-analysis. Biometrics 74(3):785–794
doi: 10.1111/biom.12817
Parr NJ, Schweer-Collins ML, Darlington TM, Tanner-Smith EE (2019) Meta-analytic approaches for examining complexity and heterogeneity in studies of adolescent development. J Adolesc 77:168–178
doi: 10.1016/j.adolescence.2019.10.009
Veroniki AA, Jackson D, Viechtbauer W, Bender R, Bowden J, Knapp G et al (2016) Methods to estimate the between-study variance and its uncertainty in meta-analysis. Res Synth Methods 7(1):55–79
doi: 10.1002/jrsm.1164
West SL, Gartlehner G, Mansfield AJ, Poole C, Tant E, Lenfestey N, et al (2010) Table 7, Summary of common statistical approaches to test for heterogeneity [Internet]. Agency for Healthcare Research and Quality (US). Available from: https://www.ncbi.nlm.nih.gov/books/NBK53317/table/ch3.t2/
Lesson 11: Influential Points. [cited 2024 Apr 4]. Available from: https://online.stat.psu.edu/stat501/book/export/html/973
van Enst WA, Ochodo E, Scholten RJ, Hooft L, Leeflang MM (2014) Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study. BMC Med Res Methodol 14(1):70
doi: 10.1186/1471-2288-14-70
Nyaga VN, Arbyn M (2024) Methods for meta-analysis and meta-regression of binomial data: concepts and tutorial with Stata command metapreg. Arch Public Health 82(1):14
doi: 10.1186/s13690-023-01215-y
Gjerdevik M, Heuch I (2014) Improving the error rates of the Begg and Mazumdar test for publication bias in fixed effects meta-analysis. BMC Med Res Methodol 14(1):109
doi: 10.1186/1471-2288-14-109
Download R-4.3.1 for Windows. The R-project for statistical computing. [cited 2023 Jul 23]. Available from: https://cran.r-project.org/bin/windows/base/
Karpathiotakis M, D’Orazi V, Ortensi A, Biancucci A, Melcarne R, Borcea MC et al (2022) Intraoperative neuromonitoring and optical magnification in the prevention of recurrent laryngeal nerve injuries during total thyroidectomy. Med Kaunas Lith. 58(11):1560
Das K, Mathew AK, Assumi K, Sudhakar GVS (2022) Loupe assisted thyroidectomy: a tool for reducing complications. Indian J Otolaryngol Head Neck Surg Off Publ Assoc Otolaryngol India 74(Suppl 3):5543–5547
doi: 10.1007/s12070-021-02899-w
Saber A, Rifaat M, Ellabban GM, Gad MA (2011) Total thyroidectomy by loupe magnification: a comparative study. Eur Surg 43(1):49–54
doi: 10.1007/s10353-011-0591-0
Pata G, Casella C, Mittempergher F, Cirillo L, Salerni B (2010) Loupe magnification reduces postoperative hypocalcemia after total thyroidectomy. Am Surg 76(12):1345–1350
doi: 10.1177/000313481007601218
Testini M, Nacchiero M, Piccinni G, Portincasa P, Di Venere B, Lissidini G et al (2004) Total thyroidectomy is improved by loupe magnification. Microsurgery 24(1):39–42
doi: 10.1002/micr.10195
Chen AY, Bernet VJ, Carty SE, Davies TF, Ganly I, Inabnet WB et al (2014) American thyroid association statement on optimal surgical management of Goiter. Thyroid 24(2):181–189
doi: 10.1089/thy.2013.0291
Rao KN, Satpute S, Nagarkar NM, Singh A (2022) Revision thyroid surgery. Indian J Surg Oncol 13(1):199–207
doi: 10.1007/s13193-021-01467-6
Lukinović J, Bilić M (2020) Overview of thyroid surgery complications. Acta Clin Croat 59(Suppl 1):81–86
Sapalidis K, Papanastasiou A, Fyntanidou V, Aidoni Z, Michalopoulos N, Katsaounis A et al (2019) Comparison between magnification techniques and direct vision in thyroid surgery: a systematic review and meta-analysis. Med Kaunas Lith 55(11):725
D’Orazi V, Panunzi A, Di Lorenzo E, Ortensi AL, Cialini M, Anichini S et al (2016) Use of loupes magnification and microsurgical technique in thyroid surgery: ten years experience in a single center. Il G Chir 37(3):101–107
Radwan MMF, Kaddah SN, ElTagy GH, Abdullateef KS (2023) High magnification versus optical magnification in hypospadias surgery: a randomized controlled trial. Ann Pediatr Surg 19(1):38
doi: 10.1186/s43159-023-00268-6
Baker JM, Meals RA (1997) A practical guide to surgical loupes. J Hand Surg 22(6):967–974
doi: 10.1016/S0363-5023(97)80034-2
McClelland E, Marzouk S, Coyle P, Tatla T (2019) Optical loupes: a useful tool for the oncall otorhinolaryngologist—our experience. Indian J Otolaryngol Head Neck Surg 71(Suppl 1):137–141
doi: 10.1007/s12070-017-1158-6
Hopper AN, Jamison MH, Lewis WG (2007) Learning curves in surgical practice. Postgrad Med J 83(986):777–779
doi: 10.1136/pgmj.2007.057190