Role of pre‐operative embolization in carotid body tumor surgery according to Shamblin classification: A systematic review and meta‐analysis

Author:

Napoli Gianluigi1,Tritto Rocco1,Moscarelli Marco2,Forleo Cinzia1,La Marca Maria Grazia Carmela3,Yang Lin4ORCID,Biondi‐Zoccai Giuseppe56,Giordano Arturo7,Tshomba Yamume8,Pepe Martino1ORCID

Affiliation:

1. Cardiovascular Diseases Section, Department of Interdisciplinary Medicine (DIM) University of Bari Bari Italy

2. Cardiothoracic and Vascular Department Maria Cecilia Hospital GVM Care & Research Cotignola Ravenna Italy

3. Vascular Surgery Unit “Di Venere” Hospital Bari Italy

4. Department of Vascular Surgery The First Affiliated Hospital of Xi'an Jiaotong University Xi'an China

5. Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome Latina Latina Italy

6. Mediterranea Cardiocentro Napoli Naples Italy

7. Invasive Cardiology Unit “Pineta Grande” Hospital Castel Volturno Caserta Italy

8. Unit of Vascular Surgery Fondazione Policlinico Universitario A. Gemelli IRCCS‐Università Cattolica del Sacro Cuore Roma Italy

Abstract

AbstractBackgroundPre‐operative embolization prior to surgical resection of carotid body tumors was meant to decrease intraoperative blood loss and operative time. Yet, potential confounders such as different Shamblin classes have never been analyzed. Aim of our meta‐analysis was to investigate effectiveness of a pre‐operative embolization according to different Shamblin classes.MethodsFive studies comprising 245 patients were included. A random effects model meta‐analysis was conducted, and the I2 statistic was used to assessment for heterogeneity.ResultsPre‐operative embolization was associated with a significant reduction in blood loss (WM: 276.4 mL; 95% CI, 201.9–378.3, p < 0.01); an absolute mean reduction, though not statistically significant, was observed in both Shamblin 2 and 3 classes. No difference in operative time was found between the two strategies (WM: 192.0 min; 95% CI, 157.7–234.1, p = 1.0).ConclusionsEmbolization proved an overall significant reduction in perioperative bleeding, which did not reach threshold for statistical significance when Shamblin classes were singularly considered.

Publisher

Wiley

Subject

Otorhinolaryngology

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