ORIGINAL ARTICLE   

Minerva Surgery 2021 April;76(2):165-72

DOI: 10.23736/S2724-5691.20.08317-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Advantages of intraoperative nerve monitoring in endoscopic thyroidectomy for papillary thyroid carcinoma

Jiyang LI ^{1, 2}, Shaoqing LI ^{1, 2}, Chen LIU ³, Hongqing XI ¹, Peifa LIU ¹, Zhida CHEN ¹, Bo WEI ^{1, 2}, Lin CHEN ^{1, 2}, Zhi QIAO ¹ ✉

¹ Department of General Surgery, Chinese PLA General Hospital, Beijing, China; ² General Surgery Institute, Chinese PLA General Hospital, Beijing, China; ³ Department of Otorhinolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China

BACKGROUND: This study aimed to evaluate the feasibility and effectiveness of intraoperative nerve monitoring (IONM) for reducing the recurrent laryngeal nerve (RLN) injury risk during central compartment lymph node dissection in endoscopic thyroidectomy of papillary thyroid carcinoma (PTC).
METHODS: The prospective cohort consisted of 69 patients diagnosed with PTC undergoing endoscopic thyroidectomy via the areola approach with (N.=42) or without IONM (N.=27). Multiple logistic regression models were used to assess the association between IONM and postoperative temporary vocal cord palsy or number of retrieved lymph nodes.
RESULTS: IONM was a protective factor against temporary RLN injury. IONM use was positively correlated with number of retrieved lymph nodes (β=1.563, P=0.003). After adjustment for operation type, the result remained significant (β=1.581, P<0.001).
CONCLUSIONS: IONM use reduced the risk of temporary vocal cord palsy and increased the number of retrieved lymph nodes in endoscopic thyroidectomy via the areola approach for patients with PTC.

KEY WORDS: Thyroid cancer, papillary; Thyroidectomy; Laryngeal nerve injuries