neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.63769/1683-3295-2026-28-2-88-97neurosurgery-1849Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWСроки хирургического вмешательства как фактор, определяющий исход при травме плечевого сплетения: систематический обзор и метаанализTiming of surgery as outcome predictor in brachial plexus injury: a systematic review and meta-analysisVillamilN. D. J. L.VillamilN. D. J. L.

Боливар

Bolívar 

Flórez-PerdomoW. A.Flórez-PerdomoW. A.

Мадисон, штат Висконсин 

Madison, Wisconsin 

AcostaM.AcostaM.

Эдинбург, штат Техас 

Edinburg, Texas 

CamargoM. I.CamargoM. I.

Боливар

Bolívar 

PérezD. P. A.PérezD. P. A.

Боливар 

Bolívar 

AgrawalA.AgrawalA.

Сакет Нагар 

Saket Nagar 

Moscote-SalazarL. R.Moscote-SalazarL. R.

Luis Rafael Moscote-Salazar

Мадисон, штат Висконсин 

Madison, Wisconsin

Faculty of Medicine, University of CartagenaКолумбияFaculty of Medicine, University of CartagenaColombiaAV Healthcare Innovators, LLCСоединённые Штаты АмерикиAV Healthcare Innovators, LLCUnited StatesRenaissance Health SystemСоединённые Штаты АмерикиRenaissance Health SystemUnited StatesDepartment of Neurosurgery, All India Institute of Medical SciencesИндияDepartment of Neurosurgery, All India Institute of Medical SciencesIndia2026190620262828897Copyright © Villamil N., Flórez-Perdomo W.A., Acosta M., Camargo M.I., Pérez D., Agrawal A., Moscote-Salazar L.R., 20262026Villamil N., Flórez-Perdomo W.A., Acosta M., Camargo M.I., Pérez D., Agrawal A., Moscote-Salazar L.R.Villamil N., Flórez-Perdomo W.A., Acosta M., Camargo M.I., Pérez D., Agrawal A., Moscote-Salazar L.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1849Цель

Цель. Изучить влияние сроков проведения операции при повреждении плечевого сплетения на неврологические исходы.

Источники данных

Источники данных. Был проведен поиск в следующих базах данных: PubMed (до ноября 2022 г.); Scopus (до марта 2023 г.); Central Cochrane Registry of Controlled Trials (The Cochrane Library) (до марта 2023 г.); MEDLINE (Ovid) и EMBASE (Ovid) (до ноября 2023 г.); CINAHL (до марта 2023 г.). 

Отбор публикаций

Отбор публикаций. Были отобраны все публикации, включавшие информацию о сроках проведения операции по поводу повреждения плечевого сплетения, неврологических и функциональных исходах.

Извлечение данных

Извлечение данных. Для определения влияния сроков проведения операции на исходы повреждений плечевого сплетения мы выполнили метаанализ следующих переменных: тип исследования, год публикации, число пациентов, уровень повреждения, предоперационное обследование, отсрочка операции, ведение периоперационного периода, сроки наблюдения.

Синтез данных

Синтез данных. В метаанализ было включено 21 ретроспективное и проспективное наблюдательное исследование. Всего проанализированы данные 878 пациентов. Было рассчитано отношение шансов: величина эффекта составила 3.1 (95 % доверительный интервал 2,2–4,3). Таким образом, раннее проведение операции значительно улучшает неврологические исходы. Низкая гетерогенность данных показывает общую согласованность исследований. Несмотря на то что некоторые исследования, такие как J.N. Goubier и соавт. (2011) и M. Socolovsky и соавт. (2011), показали более сильные эффекты, результаты анализа указывают на то, что сроки проведения операции играют ключевую роль в неврологическом восстановлении.

Заключение

Заключение. Опубликованные данные указывают на то, что раннее хирургическое вмешательство у пациентов с повреждениями плечевого сплетения более эффективно, чем отсроченные операции. 

Objectives

Objectives. To evaluate the evidence of timing of surgery in Brachial plexus injury and neurological outcome.

Data sources

Data sources. The search included PubMed (until November 2022); Scopus (until March 2023); Central Cochrane Registry of Controlled Trials (The Cochrane Library) (until March 2023); MEDLINE (Ovid) until 2023; November EMBASE (Ovid); CINAHL (until March 2023). Study selection. All articles that reported assessment timing of surgery in Brachial Plexus Injury (BPI), poor neurological and functional outcome.

Data extraction

Data extraction. Study type, publication year, number of patients, level of lesion, preoperatory assessment, delayed of operation, operative management, follow up. We performed a meta-analysis for each variable which there was important data to estimate the importance of surgical time in the management of BPI.

Data synthesis

Data synthesis. 21 studies were included in the studies, which included collected data on 878 patients from retrospective and prospective observational studies. The analysis combined odds ratios, showing an overall effect of 3.1 (95 % confidence intervals 2.2–4.3), indicating that early surgery significantly improves neurological outcomes. The low heterogeneity suggests overall consistency across studies. Although studies such as Goubier et al. (2011) and Socolovsky et al. (2011) showed stronger effects, the results indicate that surgery timing plays a crucial role in neurological recovery, with early interventions being more favorable.

Conclusion

Conclusion. There is a solid foundation to support that early surgical intervention in patients with brachial plexus lesions is a more beneficial treatment than late stage interventions. 

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The authors declare that there are no conflicts of interest present.