■该网络荟萃分析旨在综合比较不同腮腺切除术切口的手术和术后结局。
■Embase,PubMed,WebofScience,和Cochrane中央控制试验登记册被搜索到2022年4月。在OpenBUGS中使用马尔可夫蒙特卡罗方法进行了完整的贝叶斯网络元分析。
■纳入了1609例患者的17项研究。13项是回顾性队列研究,三项是前瞻性队列研究,一项是随机对照研究。在大多数比较中,证据质量被评为非常低。改良整容切口(MFI)的切口满意度评分,耳后发际线切口(RAHI),V形切口(VI)高于改良Blair切口(MBIvs.MFI:平均差[MD]-1.39;95%可信区间[CrI]-2.23,-0.57)(MBIvs.RAHI:MD-2.25;95%CrI-3.40,-1.12)(MBIvs.VI:MD-2.58;95%CrI-3.71,-1.46);VI治疗的肿瘤大小小于MBI(MD5.15;95%CrI0.76,9.38)和MFI(MD5.16;95%CrI0.34,9.86);MFI中发生短暂性面瘫的风险低于MBI(OR2.13;95%CrI1.28,3.64)。手术时间没有差异,排水量,伤口感染,血肿,唾液并发症,弗雷综合征,或切口类型之间的永久性面神经麻痹。
■传统的MBI经常用于大肿瘤体积,但切口满意度评分低,术后并发症控制差。然而,新切口在切口满意度评分和并发症控制方面表现良好.需要更多的随机对照试验来比较不同的腮腺切除术切口。患者应充分了解每个切口的特点,以做出最明智的决定,以及医生的建议。
■PROSPERO,标识符CRD42022331756。
UNASSIGNED: This network meta-analysis aimed to comprehensively compare the operative and postoperative outcomes of different
parotidectomy incisions.
UNASSIGNED: Embase, PubMed, Web of Science, and Cochrane Central Register of Controlled Trials were searched up to April 2022. A complete Bayesian network meta-analysis was performed using the Markov Monte Carlo method in OpenBUGS.
UNASSIGNED: Seventeen studies with 1609 patients were included. Thirteen were retrospective cohort studies, three were prospective cohort studies, and one was a randomized controlled study. The quality of evidence was rated as very low in most comparisons. The incision satisfaction score of the modified facelift incision (MFI), retroauricular hairline incision (RAHI), V-shaped incision (VI) were higher than that of the modified Blair incision (MBI) (MBI vs. MFI: mean difference [MD] -1.39; 95% credible interval [CrI] -2.23, -0.57) (MBI vs. RAHI: MD -2.25; 95% CrI -3.40, -1.12) (MBI vs. VI: MD -2.58; 95% CrI -3.71, -1.46); the tumor size treated by VI was smaller than that by MBI (MD 5.15; 95% CrI 0.76, 9.38) and MFI (MD 5.16; 95% CrI 0.34, 9.86); and the risk of transient facial palsy in the MFI was lower than that in the MBI (OR 2.13; 95% CrI 1.28, 3.64). There were no differences in operation time, drainage volume, wound infection, hematoma, salivary complications, Frey syndrome, or permanent facial palsy between incision types.
UNASSIGNED: The traditional MBI is frequently used for large tumor volumes, but the incision satisfaction score is low and postoperative complication control is poor. However, emerging incisions performed well in terms of incision satisfaction scores and control of complications. More randomized controlled trials are needed to compare the different
parotidectomy incisions. Patients should be fully informed about the characteristics of each incision to make the most informed decision, along with the physician\'s advice.
UNASSIGNED: PROSPERO, identifier CRD42022331756.