marginally significantP<0.001
1.7%; RR 1.62; 95% CI: 1.00–2.60; P=0.05; I 2 =7%; Figure 3D ) reached a marginally significant difference, the incidence of vocal cord palsy (2.9% vs. 0.77%; RR 3.64; 95% CI: 1.96–6.78; P<0.001; I 2 =0; Figure 4A ), and total complication rate (11.5% vs. 8.0%; RR 1.45; 95% CI: 1.20–1.74; P<0.001; I 2 =0; Figure 4B ) were significantly higher in 4LND+ patients.