CLC number: R58
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Received: 2008-01-25
Revision Accepted: 2008-04-04
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Hakan CANBAZ, Musa DIRLIK, Tahsin COLAK, Koray OCAL, Tamer AKCA, Oner BILGIN, Bahar TASDELEN, Suha AYDIN. Total thyroidectomy is safer with identification of recurrent laryngeal nerve[J]. Journal of Zhejiang University Science B, 2008, 9(6): 482-488.
@article{title="Total thyroidectomy is safer with identification of recurrent laryngeal nerve",
author="Hakan CANBAZ, Musa DIRLIK, Tahsin COLAK, Koray OCAL, Tamer AKCA, Oner BILGIN, Bahar TASDELEN, Suha AYDIN",
journal="Journal of Zhejiang University Science B",
volume="9",
number="6",
pages="482-488",
year="2008",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B0820033"
}
%0 Journal Article
%T Total thyroidectomy is safer with identification of recurrent laryngeal nerve
%A Hakan CANBAZ
%A Musa DIRLIK
%A Tahsin COLAK
%A Koray OCAL
%A Tamer AKCA
%A Oner BILGIN
%A Bahar TASDELEN
%A Suha AYDIN
%J Journal of Zhejiang University SCIENCE B
%V 9
%N 6
%P 482-488
%@ 1673-1581
%D 2008
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B0820033
TY - JOUR
T1 - Total thyroidectomy is safer with identification of recurrent laryngeal nerve
A1 - Hakan CANBAZ
A1 - Musa DIRLIK
A1 - Tahsin COLAK
A1 - Koray OCAL
A1 - Tamer AKCA
A1 - Oner BILGIN
A1 - Bahar TASDELEN
A1 - Suha AYDIN
J0 - Journal of Zhejiang University Science B
VL - 9
IS - 6
SP - 482
EP - 488
%@ 1673-1581
Y1 - 2008
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B0820033
Abstract: Objective: To investigate the effect of recurrent laryngeal nerve (RLN) identification on the complications after total thyroidectomy and lobectomy. Methods: Total 134 consecutive patients undergoing total thyroidectomy or thyroid lobectomy from January 2003 to November 2004 were investigated retrospectively. Patients were divided into two groups: RLN identified (Group A) or not (Group B). The two groups were compared for RLN injury and hypocalcaemia. Results: The numbers of patients and nerves at risk were 71 and 129 in Group A, and 63 and 121 in Group B, respectively. RLN injury in Group A (0) was significantly lower than that in Group B (5 [7.9%]) patients, 7 [5.8%] nerves) for the numbers of patients (P=0.016) and nerves at risk (P=0.006). Temporary hypocalcaemia was significantly higher in Group A than in Group B (14 [24.1%] vs 6 [10.3%], P=0.049). Permanent complications in Group B were significantly higher than those in Group A (13 [20.6%] vs 4 [5.6%], P=0.009). Conclusion: RLN injury was prevented and permanent complications were decreased by identifying the whole course and branches of the recurrent laryngeal nerve during total thyroidectomy.
[1] Ardito, G., Revelli, L., D′Alatri, L., Lerro, V., Guidi, M.L., Ardito, F., 2004. Revisited anatomy of the recurrent laryngeal nerves. Am. J. Surg., 187(2):249-253.
[2] Bergamaschi, R., Becouarn, G., Ronceray, J., 1998. Morbidity of thyroid surgery. Am. J. Surg., 176(1):71-75.
[3] Betka, J., Mrzena, L., Astl, J., Nemec, J., Vlcek, P., Taudy, M., Skrivan, J., 1997. Surgical treatment strategy for thyroid gland carcinoma nodal metastases. Eur. Arch. Otorhinolaryngol., 254(s1):169-174.
[4] Bron, L.P., O′Brien, C.J., 2004. Total thyroidectomy for clinically benign disease of the thyroid gland. Br. J. Surg., 91(5):569-574.
[5] Dackiw, A.P.B., Rotstein, L.E., Clark, O.H., 2002. Computer-assisted evoked electromyography with stimulating surgical instruments for recurrent/external laryngeal nerve identification and preservation in thyroid and parathyroid operation. Surgery, 132(6):1100-1108.
[6] Dener, C., 2002. Complication rates after operations for benign thyroid disease. Acta Otolaryngol., 122(6):679-683.
[7] Erolu, A., Ünal, M., Kocaolu, H., 1998. Total thyroidectomy for differentiated thyroid carcinoma: primary and secondary operations. Eur. J. Surg. Oncol., 24(4):283-287.
[8] Harness, J.K., Fung, L., Thompson, N.W., Burney, R.E., McCleod, M.K., 1986. Total thyroidectomy: complications and technique. World J. Surg., 10(5):781-786.
[9] Hermann, M., Alk, G., Roka, R., Glaser, K., Freissmuth, M., 2002. Laryngeal recurrent nerve injury in surgery for benign thyroid diseases. Effect of nerve dissection and impact of individual surgeon in more than 27000 nerves at risk. Ann. Surg., 235(2):261-268.
[10] Hisham, A.N., Lukman, M.R., 2002. Recurrent laryngeal nerve in thyroid surgery: a critical appraisal. ANZ J. Surg., 72(12):887-889.
[11] Lo, C.Y., 2002. Parathyroid transplantation during thyroidectomy. ANZ J. Surg., 72(12):902-907.
[12] Mattig, H., Bildat, D., Metzger, B., 1998. Reducing the rate of recurrent nerve paralysis by routine exposure of the nerves in thyroid gland operations. Zentralbl. Chir., 123(1):17-20.
[13] McHenry, C.R., 2002. Patient volumes and complications in thyroid surgery. Br. J. Surg., 89(7):821-823.
[14] Megherbi, M.T., Graba, A., Abid, L., Oulmane, D., Saidani, M., Benabadji, R., 1992. Complications and squeal of benign thyroid surgery. J. Chir. (Paris), 129(1):41-46.
[15] Ozbas, S., Kocak, S., Aydıntug, S., Cakmak, A., Demirkıran, M.A., Wishart, G.C., 2005. Comparison of the complications of subtotal, near total and total thyroidectomy in the surgical management of multinodular goiter. Endocrine J., 52(2):199-205.
[16] Pappalardo, G., Guadalaxara, A., Frattaroli, F.M., Illomei, G., Falaschi, P., 1998. Total compared with subtotal thyroidectomy in benign nodular disease: personal series and review of published reports. Eur. J. Surg., 164(7):501-506.
[17] Pimpl, W., Rieger, R., Waclawiczek, H.W., Meiser, G., Zukriegel, M., Boeckl, O., 1992. Technique of recurrent laryngeal nerve exposure within the scope of interventions of the thyroid gland. Wien. Klin. Wochenschr., 104(15):439-442.
[18] Rosato, L., Avenia, N., Bernante, P., De Palma, M., Gulino, G., Nasi, P.G., Pelizzo, M.R., Pezzullo, L., 2004. Complications of thyroid surgery: analysis of a multicentric study on 14934 patients operated on in Italy over 5 years. World J. Surg., 28(3):271-276.
[19] Shaha, A.R., Jaffe, B.M., 1992. Completion thyroidectomy: a critical appraisal. Surgery, 112(6):1148-1152.
[20] Sturniolo, G., D′Alia, C., Tonante, A., Gagliano, E., Taranto, F., Lo Schiavo, M.G., 1999. The recurrent laryngeal nerve related to thyroid surgery. Am. J. Surg., 177(6):485-488.
[21] Thomusch, O., Sekulla, C., Dralle, H., 2003. Is primary total thyroidectomy justified in benign multinodular goiter? Results of a prospective quality assurance study of 45 hospitals offering different levels of care. Der Chirurg, 74(5):437-443 (In German).
[22] Wagner, H.E., Seiler, C., 1994. Recurrent laryngeal nerve injury after throid gland surgery. Br. J. Surg., 81(2):226-228.
[23] Zambudio, A.R., Rodriguez, J., Riquelme, J., Soria, T., Canteras, M., Parrilla, P., 2004. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Ann. Surg., 240(1):18-25.
[24] Zedenius, J., Wadstrom, C., Delbridge, L., 1999. Routine autotransplantation of at least one parathyroid gland during total thyroidectomy may reduce permanent hypoparathyroidism to zero. ANZ J. Surg., 69(11):794-797.
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