1233 Role of Preoperative Embolization in the Surgical Management of Carotid Body Tumors: A Systematic Review and Meta-AnalysisM G Kaya, S Romagnoli, T J Mandigers, D Bissacco, M Domanin, Al Settembrini, S Trimarchi
The role of preoperative embolization in the surgical management of carotid body tumors (CBT) remains a topic of debate. The aim of this study was to evaluate the effect of preoperative embolization on CBT resection.
A systematic review and meta-analysis was conducted following the PRISMA protocol. Pubmed, Scopus and Web of Science were screened for studies published between 2010-2022. Primary outcomes investigated were intraoperative blood loss, operative time, length of hospital stay, and perioperative complications such as TIA/stroke, vascular injury and cranial nerve injury. Quality assessment of selected studies was performed using the Newcastle-Ottawa Scale (NOS). Publication bias was assessed using funnel plots and Egger’s regression test.
Twenty-five studies were included in the systematic review, involving 1649 patients. Twenty-three studies were eligible for meta-analysis. The incidence of vascular injury necessitating intervention was significantly less in the preoperative embolization group (OR = 0.60; 95% CI: 0.42-0.84; P = .003). There was no statistically significant difference between the two groups with regards to intraoperative blood loss, operative time, length of hospital stay, incidence of TIA/stroke and cranial nerve injury. Subgroup analyses did not show significant difference between Shamblin I, II and III subgroups with regards to operative time.
This systematic review and meta-analysis found preoperative embolization to be significantly beneficial in reducing vascular injury. No statistically significant difference was found between the two groups regarding intraoperative blood loss, operative time, length of hospital stay and complications such as TIA/stroke and cranial nerve injury.