甲状腺手术中灼烧剂的替代来源与喉神经复发性损伤的风险：国家外科手术质量改进计划的回顾性风险调整分析》。

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2024-01-01 DOI:10.1177/19160216241265687

Corliss A E Best, Jumana Hussain, Stephanie Johnson-Obaseki

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引用次数: 0

摘要

目的：利用国家外科质量改进计划（NSQIP）的数据完成一项风险调整分析，比较使用传统烧灼法和替代烧灼法（定义为 Harmonic Scalpel© 和 LigaSure©）进行甲状腺手术的喉返神经损伤率：利用 NSQIP 数据库完成了一项回顾性队列研究，研究对象为 2016 年至 2018 年期间接受甲状腺全切术、甲状腺次全切术或甲状腺完全切除术的成年患者。主要结局指标为喉返神经损伤。暴露变量为使用传统或替代烧灼源。进行了多变量线性和逻辑回归分析，以控制潜在的混杂变量：共分析了13961个病例，其中9450个病例使用了替代烧灼法，4511个病例使用了传统烧灼法。两种烧灼法的术后喉返神经损伤率没有明显差异：结论：在选择甲状腺手术的烧灼方法时，喉返神经损伤的风险不应作为考虑因素。因此，可以考虑成本效益等其他因素。

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Alternative Sources of Cautery in Thyroid Surgery and the Risk of Recurrent Laryngeal Nerve Injury: A Retrospective, Risk-Adjusted Analysis From the National Surgical Quality Improvement Program.

Objectives: A risk-adjusted analysis was completed using data from the National Surgical Quality Improvement Program (NSQIP) to compare the rates of recurrent laryngeal nerve injury in thyroid surgery using traditional versus alternative sources of cautery (defined as Harmonic Scalpel^© and LigaSure^©).

Methods: A retrospective cohort study was completed using the NSQIP database on adult patients who underwent total thyroidectomy, subtotal thyroidectomy, or completion thyroidectomy between 2016 and 2018. The primary outcome measure was recurrent laryngeal nerve injury. The exposure variable was use of conventional or alternative sources of cautery. Multivariable linear and logistic regression analyses were performed to control for potentially confounding variables.

Results: A total of 13,961 cases were analyzed; 9450 used alternative sources of cautery compared to 4511 where traditional cautery was used. There was no significant difference in rates of postoperative recurrent laryngeal nerve injury between the 2 sources of cautery compared.

Conclusions: Risk of recurrent laryngeal nerve injury should not be a factor when choosing method of cautery for thyroid surgery. Therefore, other factors like cost-effectiveness can be considered.

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来源期刊

Journal of Otolaryngology - Head & Neck Surgery 医学-耳鼻喉科学

CiteScore

6.50

自引率

2.90%

发文量

审稿时长

6 weeks

期刊介绍： Journal of Otolaryngology-Head & Neck Surgery is an open access, peer-reviewed journal publishing on all aspects and sub-specialties of otolaryngology-head & neck surgery, including pediatric and geriatric otolaryngology, rhinology & anterior skull base surgery, otology/neurotology, facial plastic & reconstructive surgery, head & neck oncology, and maxillofacial rehabilitation, as well as a broad range of related topics.