Objective To explore the clinical significance of exposure the recurrent laryngeal nerve(RLN) for preventing the RLN injury in thyroidectomy.
Methods The data of 1 723 patients with thyroid diseases undergoing total or subtotal thyroidectomy from September 2006 to August 2011 were retrospectively reviewed. RLN were exposed in 914 cases, 1 203 RLNs were exposed(exposed group). RLN were unexposed in 809 cases, 1 013 sides were cut(unexposed group). To compare RLN injury rate after operation and recovery of vocal cord in 6 months after operation between the two groups.
Results In exposed group, 11 cases had RLN injury, the rate of RLN lesion was 0.91%. In unexposed group, 21 cases had RLN injury, the rate of RLN lesion was 2.07%. The differences between the two groups had statistical significance(P<0.05). When six months after operation, 0 case and 13 cases in exposed group and unexposed group respectively occurred permanent RLN injury, the differences between the two groups had statistical significance(P<0.01).
Conclusion Exposure of RLN in total and subtotal thyroidectomy can significant avoid RLN injury, especially RLN permanent injury.
Citation:
DONG Jingqing,LEI Shangtong,.. Clinical Significance on Exposure of Recurrent Laryngeal Nerve in Thyroid Surgery Avoiding Recurrent Laryngeal Nerve Injury. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(3): 297-299. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
1. |
王昱. 甲状腺手术常规显露喉返神经的价值 [J]. 中国误诊学杂志, 2009, 9(28):6868-6869.
|
2. |
张少强, 李随勤, 闫利英, 等. 甲状腺手术中喉返神经显露的意义 [J]. 中国耳鼻咽喉头颈外科, 2006, 13(6):361-363.
|
3. |
高下, 赵德安, 黄维国, 等. 甲状腺切除病例喉返神经损伤的分析 [J]. 临床耳鼻咽喉科杂志, 2000, 14(7):315-316.
|
4. |
赵俊, 孙善全. 甲状腺手术区喉返神经及其分支的应用解剖研究 [J]. 中华外科杂志, 2001, 39(4):317-319.
|
5. |
燕速, 窦拉加, 张成武, 等.显露喉返神经的甲状腺手术临床随机对照研究 [J] . 青海医学院学报, 2009, 30(1):64-68.
|
6. |
赵松青. 甲状腺腺叶切除术中显露喉返神经与预防损伤的关系探讨 [J]. 江西医药, 2010, 45(6):541-542.
|
7. |
刘春萍, 黄韬. 甲状腺手术喉返神经损伤的原因及处理探讨 [J]. 中国普外基础与临床杂志, 2008, 15(5):314-317.
|
8. |
张诚华, 姚清勇, 董少良, 等. 甲状腺手术喉返神经损伤原因分析 [J]. 中国普通外科杂志, 2000, 9(6):564-565.
|
9. |
赵铭, 孟昭忠. 甲状腺肿瘤手术喉返神经损伤的研究 [J]. 中华普通外科杂志, 1997, 12(3):176-177.
|
10. |
王永福, 陈建超. 甲状腺手术中喉返神经损伤原因分析[ J].中国普外基础与临床杂志, 2003, 10(3):229-229.
|
11. |
刘寒冰. 囊内切除法在甲状腺手术中的应用意义 [J]. 河南外科学杂志, 2008, 14(3):14-15.
|
12. |
杨俊杰, 王勇攀, 张宁, 等. 囊内法甲状腺腺叶切除术166 例分析 [J]. 现代实用医学, 2009, 21(10):1116, 1124.
|
13. |
Procacciante F, Picozzi P, Pacifici M, et al. Palpatory method used to identify the recurrent laryngeal nerve during thyroidectomy[J]. World J Surg, 2000, 24(5): 571-573.
|
14. |
凌韶军. 显露与未显露喉返神经的甲状腺手术致喉返神经损伤的比较 [J]. 当代医学, 2011, 17(20):98-99.
|
15. |
Lahey FH, Hoover WB. Injuries to the recurrent laryngeal nerve in thyroid operations: their management and avoidance [J]. Ann Surg, 1938, 108(4): 545-562.
|
16. |
Marcus B, Edwards B, Yoo S, et al. Recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery: the University of Michigan experience [J]. Laryngoscope, 2003, 113(2):356-361.
|
17. |
宋国权, 姜国忠, 兰秀芬. 甲状腺手术中避免喉返神经损伤1 130 例分析 [J]. 中国误诊学杂志, 2007, 7(21):5065-5066.
|
18. |
张海添, 陆云飞, 廖清华, 等. 甲状腺手术中显露喉返神经价值的Meta 分析 [J]. 中华普通外科杂志, 2005, 20(4):204-206.
|
19. |
孙素红, 程晓明. 显露与未显露喉返神经的甲状腺手术致喉返神经损伤的比较 [J]. 重庆医学, 2010, 39(13):1730-1731.
|
20. |
何平, 张小斌, 刘万涛, 等. 甲状腺腺叶切除术中显露喉返神经的意义 [J]. 江西医药 , 2010, 45(4):285-287.
|
21. |
徐长青, 叶丽. 甲状腺手术显露喉返神经的意义 [J]. 中国实用医药, 2010, 5(27):44-45.
|
22. |
孙辉, 刘晓莉, 张大奇, 等.甲状腺手术中喉返神经保护及检测的临床应用 [J]. 中国普外基础与临床杂志, 2010, 17(8):768-771.
|
23. |
Hemmerling TM, Schmidt J, Bosert C, et al. Intraoperative monitoring of the recurrent laryngeal nerve in 151 consecutive patients undergoing thyroid surgery [J]. Anesth Analg, 2001,93(2): 396-399.
|
24. |
Tomoda C, Hirokawa Y, Uruno T, et al. Sensitivity and specificity of intraoperative recurrent laryngeal nerve stimulation test for predicting vocal cord palsy after thyroid surgery [J]. World J Surg, 2006, 30(7): 1230-1233.
|
25. |
符活, 张国庆. 甲状腺切除术中喉返神经损伤的防治 [J]. 中国普外基础与临床杂志, 2009, 16(9):762-762.
|
- 1. 王昱. 甲状腺手术常规显露喉返神经的价值 [J]. 中国误诊学杂志, 2009, 9(28):6868-6869.
- 2. 张少强, 李随勤, 闫利英, 等. 甲状腺手术中喉返神经显露的意义 [J]. 中国耳鼻咽喉头颈外科, 2006, 13(6):361-363.
- 3. 高下, 赵德安, 黄维国, 等. 甲状腺切除病例喉返神经损伤的分析 [J]. 临床耳鼻咽喉科杂志, 2000, 14(7):315-316.
- 4. 赵俊, 孙善全. 甲状腺手术区喉返神经及其分支的应用解剖研究 [J]. 中华外科杂志, 2001, 39(4):317-319.
- 5. 燕速, 窦拉加, 张成武, 等.显露喉返神经的甲状腺手术临床随机对照研究 [J] . 青海医学院学报, 2009, 30(1):64-68.
- 6. 赵松青. 甲状腺腺叶切除术中显露喉返神经与预防损伤的关系探讨 [J]. 江西医药, 2010, 45(6):541-542.
- 7. 刘春萍, 黄韬. 甲状腺手术喉返神经损伤的原因及处理探讨 [J]. 中国普外基础与临床杂志, 2008, 15(5):314-317.
- 8. 张诚华, 姚清勇, 董少良, 等. 甲状腺手术喉返神经损伤原因分析 [J]. 中国普通外科杂志, 2000, 9(6):564-565.
- 9. 赵铭, 孟昭忠. 甲状腺肿瘤手术喉返神经损伤的研究 [J]. 中华普通外科杂志, 1997, 12(3):176-177.
- 10. 王永福, 陈建超. 甲状腺手术中喉返神经损伤原因分析[ J].中国普外基础与临床杂志, 2003, 10(3):229-229.
- 11. 刘寒冰. 囊内切除法在甲状腺手术中的应用意义 [J]. 河南外科学杂志, 2008, 14(3):14-15.
- 12. 杨俊杰, 王勇攀, 张宁, 等. 囊内法甲状腺腺叶切除术166 例分析 [J]. 现代实用医学, 2009, 21(10):1116, 1124.
- 13. Procacciante F, Picozzi P, Pacifici M, et al. Palpatory method used to identify the recurrent laryngeal nerve during thyroidectomy[J]. World J Surg, 2000, 24(5): 571-573.
- 14. 凌韶军. 显露与未显露喉返神经的甲状腺手术致喉返神经损伤的比较 [J]. 当代医学, 2011, 17(20):98-99.
- 15. Lahey FH, Hoover WB. Injuries to the recurrent laryngeal nerve in thyroid operations: their management and avoidance [J]. Ann Surg, 1938, 108(4): 545-562.
- 16. Marcus B, Edwards B, Yoo S, et al. Recurrent laryngeal nerve monitoring in thyroid and parathyroid surgery: the University of Michigan experience [J]. Laryngoscope, 2003, 113(2):356-361.
- 17. 宋国权, 姜国忠, 兰秀芬. 甲状腺手术中避免喉返神经损伤1 130 例分析 [J]. 中国误诊学杂志, 2007, 7(21):5065-5066.
- 18. 张海添, 陆云飞, 廖清华, 等. 甲状腺手术中显露喉返神经价值的Meta 分析 [J]. 中华普通外科杂志, 2005, 20(4):204-206.
- 19. 孙素红, 程晓明. 显露与未显露喉返神经的甲状腺手术致喉返神经损伤的比较 [J]. 重庆医学, 2010, 39(13):1730-1731.
- 20. 何平, 张小斌, 刘万涛, 等. 甲状腺腺叶切除术中显露喉返神经的意义 [J]. 江西医药 , 2010, 45(4):285-287.
- 21. 徐长青, 叶丽. 甲状腺手术显露喉返神经的意义 [J]. 中国实用医药, 2010, 5(27):44-45.
- 22. 孙辉, 刘晓莉, 张大奇, 等.甲状腺手术中喉返神经保护及检测的临床应用 [J]. 中国普外基础与临床杂志, 2010, 17(8):768-771.
- 23. Hemmerling TM, Schmidt J, Bosert C, et al. Intraoperative monitoring of the recurrent laryngeal nerve in 151 consecutive patients undergoing thyroid surgery [J]. Anesth Analg, 2001,93(2): 396-399.
- 24. Tomoda C, Hirokawa Y, Uruno T, et al. Sensitivity and specificity of intraoperative recurrent laryngeal nerve stimulation test for predicting vocal cord palsy after thyroid surgery [J]. World J Surg, 2006, 30(7): 1230-1233.
- 25. 符活, 张国庆. 甲状腺切除术中喉返神经损伤的防治 [J]. 中国普外基础与临床杂志, 2009, 16(9):762-762.