Refining postoperative monitoring of recurrent laryngeal nerve injury in esophagectomy patients through transcutaneous laryngeal ultrasonography.

IF 2.2 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Esophagus Pub Date : 2024-04-01 Epub Date: 2023-12-22 DOI:10.1007/s10388-023-01036-6

Yi Zhu, Shanling Xu, Xiangnan Teng, Rui Zhao, Lin Peng, Qiang Fang, Wenguang Xiao, Zhuolin Jiang, Yanjie Li, Xinyi Luo, Yongtao Han, Hiroyuki Daiko, Xuefeng Leng

{"title":"Refining postoperative monitoring of recurrent laryngeal nerve injury in esophagectomy patients through transcutaneous laryngeal ultrasonography.","authors":"Yi Zhu, Shanling Xu, Xiangnan Teng, Rui Zhao, Lin Peng, Qiang Fang, Wenguang Xiao, Zhuolin Jiang, Yanjie Li, Xinyi Luo, Yongtao Han, Hiroyuki Daiko, Xuefeng Leng","doi":"10.1007/s10388-023-01036-6","DOIUrl":null,"url":null,"abstract":"Background: Recurrent laryngeal nerve injury (RLNI) leading to vocal cord paralysis (VCP) is a significant complication following minimally invasive esophagectomy (MIE) with upper mediastinal lymphadenectomy. Transcutaneous laryngeal ultrasonography (TLUSG) has emerged as a non-invasive alternative to endoscopic examination for evaluating vocal cord function. Our study aimed to assess the diagnostic value of TLUSG in detecting RLNI by evaluating vocal cord movement after MIE.Methods: This retrospective study examined 96 patients with esophageal cancer who underwent MIE between January 2021 and December 2022, using both TLUSG and endoscopy.Results: VCP was observed in 36 out of 96 patients (37.5%). The incidence of RLNI was significantly higher on the left side than the right (29.2% vs. 5.2%, P < 0.001). Postoperative TLUSG showed a sensitivity and specificity of 88.5% (31/35) and 86.5% (45/52), respectively, with an AUC of 0.869 (P < 0.001, 95% CI 0.787-0.952). The percentage agreement between TLUSG and endoscopy in assessing VCP was 87.4% (κ = 0.743).Conclusions: TLUSG is a highly effective screening tool for VCP, given its high sensitivity and specificity. This can potentially eliminate the need for unnecessary endoscopies in about 80% of patients who have undergone MIE.","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"141-149"},"PeriodicalIF":2.2000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Esophagus","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10388-023-01036-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/22 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Recurrent laryngeal nerve injury (RLNI) leading to vocal cord paralysis (VCP) is a significant complication following minimally invasive esophagectomy (MIE) with upper mediastinal lymphadenectomy. Transcutaneous laryngeal ultrasonography (TLUSG) has emerged as a non-invasive alternative to endoscopic examination for evaluating vocal cord function. Our study aimed to assess the diagnostic value of TLUSG in detecting RLNI by evaluating vocal cord movement after MIE.

Methods: This retrospective study examined 96 patients with esophageal cancer who underwent MIE between January 2021 and December 2022, using both TLUSG and endoscopy.

Results: VCP was observed in 36 out of 96 patients (37.5%). The incidence of RLNI was significantly higher on the left side than the right (29.2% vs. 5.2%, P < 0.001). Postoperative TLUSG showed a sensitivity and specificity of 88.5% (31/35) and 86.5% (45/52), respectively, with an AUC of 0.869 (P < 0.001, 95% CI 0.787-0.952). The percentage agreement between TLUSG and endoscopy in assessing VCP was 87.4% (κ = 0.743).

Conclusions: TLUSG is a highly effective screening tool for VCP, given its high sensitivity and specificity. This can potentially eliminate the need for unnecessary endoscopies in about 80% of patients who have undergone MIE.

Abstract Image

查看原文本刊更多论文

通过经皮喉部超声波检查完善对食管切除术患者喉返神经损伤的术后监测。

背景：喉返神经损伤（RLNI）导致声带麻痹（VCP）是微创食管切除术（MIE）和上纵隔淋巴结切除术后的一个重要并发症。经皮喉超声检查（TLUSG）已成为评估声带功能的内窥镜检查的无创替代方法。我们的研究旨在通过评估 MIE 术后声带运动的情况，评估经皮喉超声检查在检测 RLNI 方面的诊断价值：这项回顾性研究对 2021 年 1 月至 2022 年 12 月间接受 MIE 的 96 例食管癌患者进行了检查，同时使用了 TLUSG 和内窥镜：96例患者中有36例（37.5%）观察到VCP。左侧 RLNI 的发生率明显高于右侧（29.2% 对 5.2%，P 结论：TLUSG 是一种非常有效的内镜检查方法：TLUSG 具有很高的灵敏度和特异性，是一种非常有效的 VCP 筛查工具。这有可能使约 80% 接受过 MIE 的患者不再需要进行不必要的内窥镜检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Esophagus GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.90

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： Esophagus, the official journal of the Japan Esophageal Society, introduces practitioners and researchers to significant studies in the fields of benign and malignant diseases of the esophagus. The journal welcomes original articles, review articles, and short articles including technical notes ( How I do it ), which will be peer-reviewed by the editorial board. Letters to the editor are also welcome. Special articles on esophageal diseases will be provided by the editorial board, and proceedings of symposia and workshops will be included in special issues for the Annual Congress of the Society.