Extracervical Approaches to Substernal Thyroid Goiter Resection: A Systematic Review and Meta-Analysis.
OTO Open
; 8(1): e103, 2024.
Article
em En
| MEDLINE
| ID: mdl-38223493
ABSTRACT
Objective:
To evaluate the prevalence of extracervical approaches (ECAs) for substernal goiter (SSG) excision. Data Sources Search strategies created in collaboration with a medical librarian were implemented using PubMed, Cochrane, Scopus, Web of Science, and Google Scholar from inception to July 2021. ReviewMethods:
Participants included adults ages >18 years undergoing SSG excision. The primary outcome was rate of ECA via sternotomy or thoracotomy. Studies were categorized into the 3 most common distinct definitions goiter descending below the plane of the thoracic inlet (definition 1), ≥50% of thyroid mass extending below the sternal notch (definition 2), and goiter extending ≥3 cm below the suprasternal notch when the neck is hyperextended (definition 3). Two reviewers independently extracted data for analysis and performed a quality assessment using the Methodological Index for Non-Randomized Studies criteria.Results:
Of the 551 studies identified, 69 studies were included for analysis. Definition 1 included 3441 patients from 31 studies; definition 2 included 2957 patients from 26 studies; and definition 3 included 2921 patients from 12 studies. A random-effect model estimating the pooled prevalence of ECA using definition 1 resulted in prevalence of 6.12% (95% confidence interval 3.48-9.34, I 2 = 90.72%).Conclusion:
Extension below the thoracic inlet is the most widely used definition of SSG. Approximately 6% of patients with a SSG undergo an ECA. Patients with SSG undergoing surgery should be counseled on the prevalence, risks, and morbidity of an ECA in the rare occurrence it is needed.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Risk_factors_studies
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Systematic_reviews
Idioma:
En
Revista:
OTO Open
/
OTO open
Ano de publicação:
2024
Tipo de documento:
Article