Comparative Effectiveness and Safety of Energy Devices for Thyroidectomy: An Outcome-Specific Network Meta-Analysis of Randomized Controlled Trials.

IF 2.2 3区医学 Q1 OTORHINOLARYNGOLOGY

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck Pub Date : 2026-10-27 DOI:10.1002/hed.70524

Do Hyun Kim, David W Jang, Se Hwan Hwang

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引用次数: 0

Abstract

Background: We performed an outcome-specific network meta-analysis comparing contemporary energy devices in thyroidectomy.

Methods: Randomized controlled trials comparing conventional hemostasis with Harmonic, LigaSure, Thunderbeat, or other advanced energy devices during thyroidectomy were included. Frequentist random-effects network meta-analyses were performed per outcome, with treatments ranked by P-scores and consistency assessed via design-by-treatment interaction and node-splitting analyses.

Results: Compared to conventional hemostasis, Harmonic significantly reduced operative time (SMD, -1.88), blood loss (SMD, -2.29), drainage volume (SMD, -1.77), hospital stay (SMD, -0.74), transient hypocalcemia (OR, 0.61), transient recurrent laryngeal nerve palsy (OR, 0.63), and postoperative bleeding (OR, 0.56). LigaSure improved operative efficiency but showed less consistent recovery and safety benefits. Harmonic ranked highest across most outcomes.

Conclusions: Harmonic showed the most favorable relative effects across the evaluated outcomes. However, these findings do not establish overall device superiority; selection should consider absolute benefits and device-specific characteristics.

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甲状腺切除术中能量装置的相对有效性和安全性：随机对照试验的结果特异性网络荟萃分析。

背景：我们进行了一项结果特异性网络荟萃分析，比较当代甲状腺切除术中的能量装置。方法：随机对照试验比较常规止血与调和，LigaSure, Thunderbeat，或其他先进的能量装置甲状腺切除术。对每个结果进行频率随机效应网络荟萃分析，通过p得分对治疗进行排名，并通过设计-治疗相互作用和节点分裂分析评估一致性。结果：与常规止血相比，谐波止血显著减少了手术时间（SMD, -1.88）、出血量（SMD, -2.29）、引流量（SMD, -1.77）、住院时间（SMD, -0.74）、一过性低钙血症（OR, 0.61）、一过性喉返神经麻痹（OR, 0.63）和术后出血（OR, 0.56）。LigaSure提高了手术效率，但在恢复和安全性方面表现不太一致。谐波在大多数结果中排名最高。结论：谐波显示了最有利的相对效果在所有评估结果。然而，这些发现并不能建立整体的设备优势；选择时应考虑绝对收益和特定于设备的特性。

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

Head and Neck-Journal for the Sciences and Specialties of the Head and Neck 医学-耳鼻喉科学

CiteScore

7.00

自引率

6.90%

发文量

278

审稿时长

1.6 months

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.