Abstract：
BACKGROUND: Hypothyroidism is common postlaryngectomy and is associated with laryngectomy-specific complications. The objective of this study is to determine the incidence and predictors of hypothyroidism postlaryngectomy and its associated complications.
METHODS: Systematic review, data extraction, and meta-analyses were performed following the PRISMA protocol. Six databases were searched for studies reporting on postlaryngectomy thyroid status with incidence, risk factors, management, or complications.
RESULTS: Fifty-one studies with 6333 patients were included. The pooled incidence of postlaryngectomy hypothyroidism is 49% (CI 42%-57%). Subgroup analysis showed postlaryngectomy hypothyroidism rates significantly correlated with hemithyroidectomy and radiotherapy. Patients who underwent laryngectomy, hemithyroidectomy, and radiotherapy had a 65% (CI 59%-71%) rate of hypothyroidism; laryngectomy and hemithyroidectomy 46% (CI 33%-60%); laryngectomy and radiotherapy 26% (CI 19%-35%); and laryngectomy alone 11% (CI 4%-27%) (p < 0.001).
CONCLUSIONS: Laryngectomized patients with partial thyroidectomy or radiation therapy are at significant risk of postoperative hypothyroidism. Evidence-based protocols for early detection and (prophylactic) treatment should be established.
METHODS: Systematic review, data extraction, and meta-analyses were performed following the PRISMA protocol. Six databases were searched for studies reporting on postlaryngectomy thyroid status with incidence, risk factors, management, or complications.
RESULTS: Fifty-one studies with 6333 patients were included. The pooled incidence of postlaryngectomy hypothyroidism is 49% (CI 42%-57%). Subgroup analysis showed postlaryngectomy hypothyroidism rates significantly correlated with hemithyroidectomy and radiotherapy. Patients who underwent laryngectomy, hemithyroidectomy, and radiotherapy had a 65% (CI 59%-71%) rate of hypothyroidism; laryngectomy and hemithyroidectomy 46% (CI 33%-60%); laryngectomy and radiotherapy 26% (CI 19%-35%); and laryngectomy alone 11% (CI 4%-27%) (p < 0.001).
CONCLUSIONS: Laryngectomized patients with partial thyroidectomy or radiation therapy are at significant risk of postoperative hypothyroidism. Evidence-based protocols for early detection and (prophylactic) treatment should be established.
摘要：
背景：甲状腺功能减退症是常见的喉后切除术，并与喉切除术特异性并发症相关。这项研究的目的是确定喉切除术后甲状腺功能减退症及其相关并发症的发生率和预测因素。
方法：系统评价，数据提取,和meta分析按照PRISMA方案进行.在六个数据库中搜索了报告喉切除术后甲状腺状态与发病率的研究，危险因素，管理,或并发症。
结果：纳入51项研究，6333例患者。喉切除术后甲状腺功能减退症的合并发生率为49％（CI42％-57％）。亚组分析显示，喉切除术后甲状腺功能减退率与半甲状腺切除术和放疗显着相关。接受喉切除术的患者，半甲状腺切除术,放疗的甲状腺功能减退率为65%(CI59%-71%);喉切除术和半甲状腺切除术的发生率为46%(CI33%-60%);喉切除术和放疗的发生率为26%(CI19%-35%);单纯喉切除术的发生率为11%(CI4%-27%)(p<0.001).
结论：行甲状腺部分切除术或放疗的喉切除患者术后甲状腺功能减退症的风险很大。应建立早期发现和（预防性）治疗的循证协议。
方法：系统评价，数据提取,和meta分析按照PRISMA方案进行.在六个数据库中搜索了报告喉切除术后甲状腺状态与发病率的研究，危险因素，管理,或并发症。
结果：纳入51项研究，6333例患者。喉切除术后甲状腺功能减退症的合并发生率为49％（CI42％-57％）。亚组分析显示，喉切除术后甲状腺功能减退率与半甲状腺切除术和放疗显着相关。接受喉切除术的患者，半甲状腺切除术,放疗的甲状腺功能减退率为65%(CI59%-71%);喉切除术和半甲状腺切除术的发生率为46%(CI33%-60%);喉切除术和放疗的发生率为26%(CI19%-35%);单纯喉切除术的发生率为11%(CI4%-27%)(p<0.001).
结论：行甲状腺部分切除术或放疗的喉切除患者术后甲状腺功能减退症的风险很大。应建立早期发现和（预防性）治疗的循证协议。
