An institutional experience of intraoperative neurophysiological monitoring application in robotic thyroidectomy: a retrospective case-control study.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2024-05-01 Epub Date: 2024-04-30 DOI:10.4174/astr.2024.106.5.243

Joon-Hyop Lee, Hyungju Kwon

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引用次数: 0

Abstract

Purpose: Intraoperative neurophysiological monitoring (IONM) has been introduced in thyroid surgery to prevent injury of the recurrent laryngeal nerve (RLN). However, its effectiveness remains controversial in robotic thyroidectomy (RT). This study aimed to compare the surgical outcome of RT in patients with and without the application of IONM.

Methods: This retrospective case-control study included 100 patients who underwent total thyroidectomy via robotic bilateral axillo-breast approach in a tertiary center. A study group of 50 patients who had IONM during RT was compared to a control group of 50 patients who underwent RT with nerve visualization alone.

Results: The sex ratio (4:45 vs. 7:43, P = 0.538), mean age (39.3 ± 7.1 years vs. 37.5 ± 10.4 years, P = 0.304), and body mass index (23.1 ± 2.6 kg/m² vs. 22.2 ± 3.9 kg/m², P = 0.215) were comparable between the IONM and control groups. Pathologic features including tumor size (0.8 cm vs. 0.9 cm, P = 0.283), extrathyroidal extension (58.0% vs. 24.0%, P = 0.316), lymph node metastasis (30% vs. 34%, P = 0.668), and number of lymph nodes (5.3 vs. 5.3, P = 0.668) showed no differences. There was no permanent RLN palsy, postoperative bleeding, and wound complications. Transient hypoparathyroidism was observed in 12 (24.0%) and 14 (28.0%), permanent hypoparathyroidism in 0 (0%) and 1 (2.0%), and transient RLN palsy was observed in 3 (6.0%) and 3 (6.0%), respectively.

Conclusion: We did not demonstrate a clear advantage of IONM in RT. Controversies regarding the effectiveness of IONM is not closed.

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在机器人甲状腺切除术中应用术中神经电生理监测的机构经验：一项回顾性病例对照研究。

目的：在甲状腺手术中引入术中神经电生理监测（IONM）是为了防止喉返神经（RLN）损伤。然而，其在机器人甲状腺切除术（RT）中的有效性仍存在争议。本研究旨在比较应用和未应用 IONM 的 RT 患者的手术效果：这项回顾性病例对照研究纳入了在一家三级中心接受机器人双侧腋窝-乳房入路甲状腺全切除术的 100 例患者。研究组的50名患者在RT过程中接受了IONM，对照组的50名患者仅接受了神经可视化RT：结果：IONM组和对照组的性别比例（4:45 vs. 7:43，P = 0.538）、平均年龄（39.3 ± 7.1岁 vs. 37.5 ± 10.4岁，P = 0.304）和体重指数（23.1 ± 2.6 kg/m2 vs. 22.2 ± 3.9 kg/m2，P = 0.215）相当。病理特征包括肿瘤大小（0.8 厘米 vs. 0.9 厘米，P = 0.283）、甲状腺外扩展（58.0% vs. 24.0%，P = 0.316）、淋巴结转移（30% vs. 34%，P = 0.668）和淋巴结数量（5.3 vs. 5.3，P = 0.668），两者无差异。没有永久性RLN麻痹、术后出血和伤口并发症。12例（24.0%）和14例（28.0%）观察到一过性甲状旁腺功能减退，0例（0%）和1例（2.0%）观察到永久性甲状旁腺功能减退，3例（6.0%）和3例（6.0%）观察到一过性RLN麻痹：结论：我们没有证明 IONM 在 RT 中的明显优势。关于IONM有效性的争议尚未结束。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).