腹腔镜外科杂志2017，Vol.22Issue(11)：801-805,5.DOI:10.13499/j.cnki.fqjwkzz.2017.11.801
喉返神经监测技术在全腔镜cT1N0～1a分化型甲状腺癌根治术中的应用体会
Application of intraoperative neuromonitoring technique in totally endoscopic radical thyroidectomy for eT1N0-1a differentiated thyroid cancer
摘要
Abstract
Objective:To explore the necessity of intraoperative neuromonitoring of recurrent laryngeal nerve in the endoscopic radical thyroidectomy for differentiated thyroid cancer in the cT1N0-1a stage.Methods:Clinical data of 106 patients who underwent endoscopic radical thyroidectomy for the cT1N0-1a differentiated thyroid cancer from Feb.2013 to Oct.2016 were analyzed comparatively.54 patients used intraoperative neuromonitoring of recurrent laryngeal nerve and 52 patients did not use this technique.The data of the two groups were compared in the aspects of identifying time of recurrent laryngeal nerve,identifying rate,temporary injury and permanent injury.Results:Only 1 patient without neuromonitoring underwent conversion to open surgery because non-recurrent laryngeal nerve was cut off by mistake and neural anastomosis was performed.All the other patients successfully received endoscopic procedures.In the identifying time and identifying rate of recurrent laryngeal nerve,the group using intraoperative neuromonitoring technique was superior to the group not using this technique,and the differences were statistically significant (P ＜ 0.05).7 recurrent laryngeal nerves were not identified definitely in the group not using intraoperative neuromonitoring.2 recurrent laryngeal nerves in the group using intraoperative neuromonitoring had temporary injury and recovered in 2 weeks or 4 weeks postoperatively.8 recurrent laryngeal nerves in the group not using this technique had temporary injury,6 nerves recovered in 2 weeks and 2 nerves recovered in 4 weeks postoperatively.There was statistical significance in the difference of temporary nerve injury between the 2 groups (P ＜ 0.05).However,there was no statistically significant difference in the permanent nerve injury between the 2 groups (P ＞ 0.05).Conclusions:Intraoperative neuromonitoring technique of recurrent laryngeal nerve could provide guarantee for safe and rapid identification of nerve and avoid severe complication of nerve injury.Especially in the early stage of development of endoscopic radical thyroidectomy for cT1N0-1a thyroid cancer,intraoperative neuromonitoring of recurrent laryngeal nerve is necessary.关键词
甲状腺肿瘤/内窥镜检查/术中神经监测Key words
Thyroid neoplasms/Endoscopy/Intraoperative neuromonitoring分类
医药卫生引用本文复制引用
费阳,姚京,王世斌,田文..喉返神经监测技术在全腔镜cT1N0～1a分化型甲状腺癌根治术中的应用体会[J].腹腔镜外科杂志,2017,22(11):801-805,5.基金项目
北京市科技计划项目(编号:Z141107002514102) （编号:Z141107002514102）
