Chronic Postsurgical Pain after Thyroidectomy: a systematic review with meta-analysis

Abstract

Background and Objective: Chronic postsurgical pain is acknowledged in significant surgical interventions, yet it is frequently disregarded in some procedures, such as thyroidectomies. Given this procedure's rising prevalence, the present study aims to summarize the existing evidence regarding Chronic Postsurgical Pain after Thyroidectomy (CPPT), exploring its incidence, characteristics, and modulating factors. Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The review comprised three phases: a methodological assessment of three different databases identifying potential articles and screening for inclusion criteria by two independent reviewers; data extraction; and study quality assessment. Meta-analyses were performed to estimate the pooled incidence rates of CPPT and neuropathic pain using a random effects model. Additionally, sensitivity and subgroup analysis were performed. Results: The initial search found a total of 241 potentially relevant papers. After a thorough evaluation, 16 papers involving 1538 patients were included in this synthesis. All 16 studies presented a low risk of bias. The pooled estimated incidence of CPPT was 18.4% (three months postoperatively). For neuropathic pain pooled estimated incidence was 40.9 % at three months and 9.5% at six months postoperatively. Conclusion: This study furthers our understanding of CPPT by precisely delineating its incidence and characteristics. Given the detrimental consequences of chronic pain, CPPT needs heightened awareness among healthcare professionals. Consequently, the implementation of targeted initiatives to address CPPT is of paramount importance.