Effectiveness of recurrent laryngeal nerve monitoring on nerve paralysis during open McKeown esophagectomy: a prospective, cohort study.

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-05-14 DOI:10.1007/s00423-025-03732-6

Shuwen Fu, Ying Guo, Xiaofan Lu, Xiong Song, Weiyi Qin, Liquan Zheng, Xiaofeng Huang, Manxiu Xie, Yali Lu, Renchun Lai

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引用次数: 0

Abstract

Background: Recurrent laryngeal nerve paralysis (RLNP) is a critical postoperative complication in esophagectomy. Intraoperative nerve monitoring (IONM) is a technique that can be used in high-risk surgeries to prevent, identify, and mitigate nerve damage. In this prospective study, we evaluated the feasibility and effectiveness of IONM in open McKeown esophagectomy for esophageal cancer.

Methods: From December 2020 to September 2023, 88 patients diagnosed with esophageal cancer were enrolled to receive IONM for open McKeown esophagectomy at Cancer Center, Sun Yat-sen University. The primary outcome was the incidence of RLNP after extubation. The secondary outcomes were postoperative complications, number of dissected lymph nodes, length of hospital stay, ICU duration and number of deaths.

Results: A total of 83 patients were included in the final analysis. The incidence of RLNP after extubation was 30.1%. The occurrence of postoperative pulmonary complications was 20.5%. The median hospital stays were 13 days. The incidence of anastomotic leakage was 13.3%. No in-hospital deaths were reported. Postoperative RLNP prolonged the length of hospital stay (P = 0.042).

Conclusion: Our findings indicated that IONM could potentially be associated with a possible reduction in RLNP incidence following open McKeown esophagectomy for esophageal cancer. However, future research including well-designed randomized controlled trials may be beneficial to clarify these preliminary results.

Trial registration number: ChiCTR2000029687 https://www.chictr.org.cn/showproj.html?proj=49103.

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喉返神经监测对开放式McKeown食管切除术中神经麻痹的有效性：一项前瞻性队列研究。

背景：喉返神经麻痹（RLNP）是食管切除术后的一个重要并发症。术中神经监测（IONM）是一种可用于高危手术预防、识别和减轻神经损伤的技术。在这项前瞻性研究中，我们评估了IONM在开放式McKeown食管切除术中治疗食管癌的可行性和有效性。方法：2020年12月至2023年9月，中山大学肿瘤中心88例确诊为食管癌的患者接受IONM行开放式McKeown食管切除术。主要观察指标为拔管后RLNP的发生率。次要结局为术后并发症、清扫淋巴结数、住院时间、ICU时间和死亡人数。结果：83例患者纳入最终分析。拔管后RLNP发生率为30.1%。术后肺部并发症发生率为20.5%。平均住院时间为13天。吻合口瘘发生率为13.3%。无院内死亡报告。术后RLNP延长了住院时间（P = 0.042）。结论：我们的研究结果表明，IONM可能与食管癌开放式McKeown食管切除术后RLNP发生率的降低有关。然而，未来的研究包括精心设计的随机对照试验可能有助于澄清这些初步结果。试验注册号：ChiCTR2000029687 https://www.chictr.org.cn/showproj.html?proj=49103。

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

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.