Effect of intraoperative nerve monitoring on postoperative vocal cord palsy rates after thyroidectomy: European multicentre registry‐based study

Autor: J I Staubitz, F Watzka, A Poplawski, P Riss, T Clerici, A Bergenfelz, T J Musholt, S Slycke, M Iacobone, L Brunaud, J Villar, M Raffaelli, D Scott-Coombes
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Intraoperative Neurophysiological Monitoring
medicine.medical_treatment
Cohort Studies
0302 clinical medicine
Recurrent laryngeal nerve
80 and over
Postoperative Period
Registries
030223 otorhinolaryngology
Child
Intraoperative Complications
Aged
80 and over
Recurrent Laryngeal Nerve
Thyroid disease
General Medicine
Middle Aged
Europe
Treatment Outcome
030220 oncology & carcinogenesis
Child
Preschool
Preoperative Period
Thyroidectomy
Regression Analysis
Original Article
Female
Vocal Cord Paralysis
Cohort study
Adult
medicine.medical_specialty
Adolescent
lcsh:Surgery
Lower risk
03 medical and health sciences
Young Adult
Preoperative Care
medicine
Aged
Humans
Multivariate Analysis
Recurrent Laryngeal Nerve Injuries
Thyroid Diseases
Vocal cord paralysis
Preschool
General
business.industry
Odds ratio
Original Articles
lcsh:RD1-811
medicine.disease
Surgery
business
Intraoperative neurophysiological monitoring
Zdroj: BJS Open, Vol 4, Iss 5, Pp 821-829 (2020)
BJS Open
ISSN: 2474-9842
Popis: Background Intraoperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) predicts the risk of vocal cord palsy (VCP). IONM can be used to adapt the surgical strategy in order to prevent bilateral VCP and associated morbidity. Controversial results have been reported in the literature for the effect of IONM on rates of VCP, and large multicentre studies are required for elucidation. Methods Patients undergoing first‐time thyroidectomy for benign thyroid disease between May 2015 and January 2019, documented prospectively in the European registry EUROCRINE®, were included in a cohort study. The influence of IONM and other factors on the development of postoperative VCP was analysed using multivariable regression analysis. Results Of 4598 operations from 82 hospitals, 3542 (77·0 per cent) were performed in female patients. IONM was used in 4182 (91·0 per cent) of 4598 operations, independent of hospital volume. Postoperative VCP was diagnosed in 50 (1·1 per cent) of the 4598 patients. The use of IONM was associated with a lower risk of postoperative VCP in multivariable analysis (odds ratio (OR) 0·34, 95 per cent c.i. 0·16 to 0·73). Damage to the RLN noted during surgery (OR 24·77, 12·91 to 48·07) and thyroiditis (OR 2·03, 1·10 to 3·76) were associated with an increased risk of VCP. Higher hospital volume correlated with a lower rate of VCP (OR 0·05, 0·01 to 0·13). Conclusion Use of IONM was associated with a low rate of postoperative VCP.
The influence of intraoperative nerve monitoring (IONM) and other factors on the development of postoperative vocal cord palsy (VCP) was assessed using multivariable regression analysis. In a cohort of 4598 patients from 82 hospitals, IONM was used in over 90 per cent of those treated by primary thyroidectomy for underlying benign thyroid disease. IONM reduced the rate of postoperative VCP. Intraoperative nerve monitoring associated with lower rates of vocal cord palsy
Databáze: OpenAIRE
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