Relationship of Recurrent Laryngeal Nerve Injury with Surgical Approach_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 秦坚 , 徐晓波 , 周致圆 , 何柳 ,  刘文勇

;

Corresponding author：

刘文勇, Email: liuwenyongyy@aliyun.com

Keywords：

喉返神经损伤; 甲状腺手术; 影响因素

DOI：

10.7507/1007-9424.20140275

Video：

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目的探讨甲状腺手术方式和喉返神经损伤（RLN）的关系。方法回顾性分析2009年1月至2012年6月期间于笔者所在医院科室接受开放性甲状腺手术的985例患者的临床资料，探讨甲状腺手术方式和RLN损伤的关系。结果本组患者术后发生RLN损伤26例（2.6%），未发生RLN损伤959例（97.4%）。logistic回归分析结果显示，年龄、性别、超声刀应用、麻醉方式及肿块良恶性与RLN损伤均无关（P＞0.05），而手术范围（OR=3.726，P=0.007）和显露RLN（OR=0.302，P=0.006）则是RLN损伤的影响因素，行扩大性手术及未显露RLN者的RLN损伤率较高。结论在开放性甲状腺手术中，手术范围以及显露RLN是RLN损伤的独立影响因素，术中显露并注意保护RLN，对避免RLN损伤具有重要意义。

Citation： 秦坚, 徐晓波, 周致圆, 何柳, 刘文勇. Relationship of Recurrent Laryngeal Nerve Injury with Surgical Approach. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(9): 1149-1151. doi: 10.7507/1007-9424.20140275 Copy

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7.	Arora N, Dhar P, Fahey TJ 3^rd.Seminars:local and regional anesthesia for thyroid surgery[J]. J Surg Oncol, 2006, 94(8):708-713.
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11.	Prim MP, de Diego JI, Hardisson D, et al.Factors related to nerve injury and hypocalcemia in thyroid gland surgery[J]. Otolaryngol Head Neck Surg, 2001, 124(1):111-114.
12.	Shindo ML, Wu JC, Park EE.Surgical anatomy of the recurrent laryngeal nerve revisited[J]. Otolaryngol Head Neck Surg, 2005, 133(4):514-519.
13.	Ardito G, Revelli L, D'alatri L, et al.Revisited anatomy of the recurrent laryngeal nerves[J]. Am J Surg, 2004, 187(2):249-253.
14.	Ahmed M, Aurangzeb, Abbas S, et al.Should we routinely expose recurrent laryngeal nerve(s) during thyroid surgery?[J]. J Coll Physicians Surg Pak, 2013, 23(3):186-189.
15.	Serpell JW, Phan D.Safety of total thyroidectomy[J]. ANZ J Surg, 2007, 77(1-2):15-19.
16.	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.

1. Moorthy R, Balfour A, Jeannon JP, et al.Recurrent laryngeal nerve palsy in benign thyroid disease:can surgery make a difference?[J]. Eur Arch Otorhinolaryngol, 2012, 269(3):983-987.
2. Erbil Y, Barbaros U, Işsever H, et al.Predictive factors for recurrent laryngeal nerve palsy and hypoparathyroidism after thyroid surgery[J]. Clin Otolaryngol, 2007, 32(1):32-37.
3. Hayward NJ, Grodski S, Yeung M, et al.Recurrent laryngeal nerve injury in thyroid surgery:a review[J]. ANZ J Surg, 2013, 83(1-2):15-21.
4. Spanknebel K, Chabot JA, Digiorgi M, et al.Thyroidectomy using local anesthesia:a report of 1025 cases over 16 years[J]. J Am Coll Surg, 2005, 201(3):375-385.
5. Akhtar N, Abbas SA. Regional anaesthesia in thyroid surgery[J]. J Coll Physicians Surg Pak, 2013, 23(12):885-887.
6. Banasiewicz T, Meissner W, Pyda P, et al.Local anesthesia in thyroid surgery-own experience and literature review[J]. Pol Przegl Chir, 2011, 83(5):264-270.
7. Arora N, Dhar P, Fahey TJ 3^rd.Seminars:local and regional anesthesia for thyroid surgery[J]. J Surg Oncol, 2006, 94(8):708-713.
8. 魏涛, 李志辉, 朱精强.超声刀与传统方法在开放甲状腺手术的临床对比研究[J]. 中国普外基础与临床杂志, 2008, 15(5):323-326.
9. Maeda S, Shimizu K, Minami S, et al.Video-assisted neck surgery for thyroid and parathyroid disea ses[J]. Biomed Pharmacother, 2002, 56 Suppl 1:92s-95s.
10. Thomusch O, Sekulla C, Dralle H.Is primary total thyroidectomy justified in benign multinodular goiter? Results of a prospective quality assurance study of 45 hospitals offering different levels of care[J]. Chirurg, 2003, 74(5):437-443.
11. Prim MP, de Diego JI, Hardisson D, et al.Factors related to nerve injury and hypocalcemia in thyroid gland surgery[J]. Otolaryngol Head Neck Surg, 2001, 124(1):111-114.
12. Shindo ML, Wu JC, Park EE.Surgical anatomy of the recurrent laryngeal nerve revisited[J]. Otolaryngol Head Neck Surg, 2005, 133(4):514-519.
13. Ardito G, Revelli L, D'alatri L, et al.Revisited anatomy of the recurrent laryngeal nerves[J]. Am J Surg, 2004, 187(2):249-253.
14. Ahmed M, Aurangzeb, Abbas S, et al.Should we routinely expose recurrent laryngeal nerve(s) during thyroid surgery?[J]. J Coll Physicians Surg Pak, 2013, 23(3):186-189.
15. Serpell JW, Phan D.Safety of total thyroidectomy[J]. ANZ J Surg, 2007, 77(1-2):15-19.
16. 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.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Relationship of Recurrent Laryngeal Nerve Injury with Surgical Approach

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