The effect of no drainage in patients who underwent thyroidectomy with neck dissection: A systematic review and meta-analysis.
The effect of no drainage in patients who underwent thyroidectomy with neck dissection: A systematic review and meta-analysis.
复制标题
不引流对接受甲状腺切除术和颈清扫术的患者的影响系统评价和荟萃分析
DOI：
10.1097/md.0000000000009052
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发表时间：
2017-12
期刊：
影响因子：
1.6
通讯作者：
Huang T
中科院分区：
文献类型：
--
作者：
Li L;Chen H;Tao H;Liu W;Li W;Leng Z;Zhao E;Huang T
补充数字内容可在文本中获得，以评价接受甲状腺切除术和颈淋巴结清扫术的患者中无引流的效果。我们遵循科克伦期望的方法学标准。截至2017年3月23日，我们检索了以下数据库：PubMed、科克伦图书馆、通过奥维德SP检索的EMBASE和通过奥维德SP检索的Medline。两名评审员筛选了研究并提取了数据。随机对照试验（RCT）或非随机干预性研究评估了甲状腺切除术后淋巴结清扫术后无引流的效果。纳入了三项研究，共387名受试者。两组之间的总体围手术期并发症（2项RCT，n = 234，RR 1.56，95% CI 0.53-4.64）或特定并发症，如血清肿（2项RCT，n = 234，RR 1.81，95% CI 0.46-7.07）、血肿（2项RCT，n = 234，RR 0.72，95% CI 0.11-4.83）或出血（1项RCT，n = 69，RR 0.29，95% CI 0.01-6.87）无统计学差异。 1项研究（n = 32）报告了引流组1例因出血需要再次手术。 未报告死亡。2项研究（n = 234）表明引流组的住院时间长于未引流组。 纳入研究的偏倚风险存在中度或严重偏倚。由于很少有研究讨论这个问题，因此在接受甲状腺切除术和颈淋巴结清扫术的甲状腺癌患者中不引流的效果仍然不确定。引流可能导致比不引流更长的住院时间。需要更多的随机或非随机研究来解决这个问题。
Supplemental Digital Content is available in the text To evaluate the effect of no drainage in patients who underwent thyroidectomy and neck lymph node dissection. We followed the methodological standard expected by Cochrane. We searched the following databases by March 23, 2017: PubMed, The Cochrane Library, EMBASE via Ovid SP, and Medline via Ovid SP. Two reviewers screened the studies and extracted the data. Randomized controlled trials (RCTs) or nonrandomized interventional studies assessing the effect of no drainage following thyroidectomy with lymph node dissection were included. Three studies with 387 participants were included. There was no statistical difference between groups for the overall perioperative complications (2 RCTs, n = 234, RR 1.56, 95% CI 0.53–4.64), or specific complications such as seroma (2 RCTs, n = 234, RR 1.81, 95% CI 0.46–7.07), hematoma (2 RCTs, n = 234, RR 0.72, 95% CI 0.11–4.83) or hemorrhage (1 RCT, n = 69, RR 0.29, 95% CI 0.01–6.87). One case required reoperation due to hemorrhage in the drainage group was reported in 1 study (n = 32). No mortality was reported. Two studies (n = 234) stated a longer hospital stay in the drainage group than that in the group without drainage. There was moderate or serious bias for the risk of bias of included studies. The effect of no-drainage in patients with thyroid cancer who received thyroidectomy with neck dissections remains uncertain, since there are very few studies that addressed the question. Drainage may lead to longer hospital stay than nondrainage. More randomized or nonrandmized studies are required to address this issue.