Utilisation of Near Infrared Autofluorescence in Parathyroid Identification During Thyroidectomy: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-04-05 DOI:10.1111/coa.14313

Azfar Javed, Abdullah Alburaiki, Neil Sharma, Mriganka De, George Garas, Ijaz Ahmad, Paul Nankivell, Anita Sonsale, Jonathan Fussey, Keshav Kumar Gupta

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引用次数: 0

Abstract

Objective

Unintentional parathyroid gland resection during total thyroidectomy can result in permanent hypoparathyroidism and lifelong replacement therapy. Near infrared autofluorescence (NIRAF) imaging may aid intraoperative identification and preservation of the parathyroid glands. This article aims to review NIRAF's effectiveness in the prevention of post-operative hypoparathyroidism.

Design

Systematic review and meta-analysis reported according to PRISMA guidelines.

Methods

The electronic databases of MEDLINE, Embase and Cochrane were searched in September 2024. Included articles were randomised controlled trials (RCTs) that studied the use of NIRAF vs. dissection with no intraoperative aids in thyroidectomy. Meta-analysis was performed using a random-effects model. Primary outcomes were postoperative hypocalcaemia and permanent hypoparathyroidism.

Results

Eight RCTs were included in the final analysis, comprising 1620 patients. Meta-analysis revealed patients undergoing thyroidectomy using NIRAF had a reduced risk of both post-operative hypocalcaemia (OR 0.56, 95% CI: 0.36–0.89, p = 0.01) and persistent hypoparathyroidism (OR 0.44, 95% CI: 0.22–0.89, p = 0.02).

Conclusions

NIRAF use in thyroidectomy reduces the risk of post-operative hypocalcaemia and post-operative hypoparathyroidism.

查看原文本刊更多论文

近红外自体荧光在甲状腺切除术中甲状旁腺识别中的应用：随机对照试验的系统回顾和荟萃分析。

目的：全甲状腺切除术中不小心切除甲状旁腺可导致永久性甲状旁腺功能减退，需终身替代治疗。近红外自身荧光（NIRAF）成像可以帮助术中识别和保存甲状旁腺。本文旨在回顾NIRAF在预防术后甲状旁腺功能减退中的有效性。设计：根据PRISMA指南进行系统评价和荟萃分析报告。方法：于2024年9月检索MEDLINE、Embase和Cochrane电子数据库。纳入的文章是随机对照试验（rct），研究了在甲状腺切除术中使用NIRAF与无术中辅助的解剖。采用随机效应模型进行meta分析。主要结局是术后低钙血症和永久性甲状旁腺功能减退。结果：最终分析纳入8项rct，共1620例患者。荟萃分析显示，使用NIRAF进行甲状腺切除术的患者术后低钙血症（OR 0.56, 95% CI: 0.36-0.89, p = 0.01）和持续性甲状旁腺功能低下（OR 0.44, 95% CI: 0.22-0.89, p = 0.02）的风险均降低。结论：NIRAF用于甲状腺切除术可降低术后低钙血症和甲状旁腺功能减退的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.