BMI对甲状腺全切除术后围手术期结局的影响：一项系统评价和荟萃分析。
Impact of BMI on perioperative outcomes following total thyroidectomy: a systematic review and meta-analysis.
文献信息
| PMID | 42875777 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Osamah Al-Adilee |
| 作者单位 | Department of Surgery (A), Medical Faculty, Heinrich-Heine-University, University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. |
| 期刊 | Thyroid research |
| SCI 分区 | Q3 |
| IF | 2.6 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 体重指数（BMI）对甲状腺全切除术（TT）后围手术期结局的影响仍存在争议。我们进行了一项系统评价和荟萃分析，以评估BMI与TT术后围手术期并发症之间的关联。
方法： 分析了12项观察性研究，共纳入22,145例接受择期TT的患者。BMI按WHO标准分类。主要结局为喉返神经（RLN）麻痹和甲状旁腺功能减退。次要结局包括手术时间、住院时间（LOS）、术后出血和手术部位感染（SSI）。采用随机效应模型。
结果： BMI与RLN麻痹无关。较低的BMI与较高的术后和暂时性甲状旁腺功能减退发生率相关，而永久性甲状旁腺功能减退无差异。较高的BMI与较长的手术时间和增加的术后出血相关。LOS和SSI在组间相当。
结论： 甲状腺全切除术在BMI升高的患者中似乎是安全的，因为未观察到BMI与预设主要结局喉返神经麻痹或永久性甲状旁腺功能减退之间存在显著关联。有趣的是，BMI较低的患者术后和暂时性甲状旁腺功能减退的发生率较高。较高的BMI与较长的手术时间相关，并可能与术后出血风险增加相关。因此，对于BMI升高的患者，应特别注意术中精细止血。
英文摘要
BACKGROUND: The influence of body mass index (BMI) on perioperative outcomes following total thyroidectomy (TT) remains controversial. We performed a systematic review and meta-analysis to evaluate the association between BMI and perioperative complications after TT.
METHODS: Twelve observational studies including 22,145 patients undergoing elective TT were analyzed. BMI was categorized per WHO criteria. Primary outcomes were recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism. Secondary outcomes included operative time, length of stay (LOS), postoperative bleeding, and surgical site infection (SSI). Random-effects models were used.
RESULTS: BMI was not associated with RLN palsy. Lower BMI was associated with higher rates of postoperative and transient hypoparathyroidism, while permanent hypoparathyroidism did not differ. Higher BMI was associated with longer operative time and increased postoperative bleeding. LOS and SSI were comparable between groups.
CONCLUSIONS: Total thyroidectomy appears to be safe in patients with elevated BMI, as no significant association was observed between BMI and the predefined primary outcomes of recurrent laryngeal nerve palsy or permanent hypoparathyroidism. Interestingly, patients with lower BMI experienced higher rates of postoperative and transient hypoparathyroidism. Higher BMI was associated with longer operative time and may be associated with an increased risk of postoperative bleeding. Therefore, particular attention should be paid to meticulous intraoperative hemostasis in patients with elevated BMI.