甲状腺软骨针电极在甲状腺手术术中神经监测中的应用:一项多中心回顾性研究。

IF 2.4 3区 医学 Q2 SURGERY
Kaan Balcı, Yiğit Türk, Murat Özdemir, Paulina Kuczma, Christophe Tresallet, Che-Wei Wu, Tzu-Yen Huang, Adi Syazni Muhammed, Rohaizak Muhammad, Shahrun Niza Bin Abdullah Suhaimi, Nani Harlina, Matija Buzejic, Vladan Zivaljevic, Milan Jovanovic, Özer Makay
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引用次数: 0

摘要

在以往的研究中,甲状腺软骨针电极(TCN)被定义为甲状腺手术中一种廉价的术中神经监测(IONM)方法。本多中心回顾性研究旨在确定TCN在甲状腺手术中的有效性和可靠性。本研究纳入了2018年1月至2023年8月期间来自五个中心的手术患者。评估患者的人口统计学资料、适应证、手术类型、IONM记录系统、切除前迷走神经(V1-V2)、切除前喉返神经(R1-R2)振幅及潜伏期值、信号丧失类型(LOS)、不良事件(AE)、术中损伤机制、术后声带检查(VCE)。排除术前声带检查异常的患者。共纳入2105例患者(3772条有危险的神经)[女性1626例(77%),男性479例(23%)];在本研究中,1112例患者(53%)被诊断为恶性肿瘤,993例(47%)被诊断为良性肿瘤。平均初始迷走神经振幅为1093.74µV(±861.39)。63例患者发生LOS[1型(84%),2型(16%)],36例发生AE。未发生假阳性LOS。46例(87%)1型LOS患者和9例(90%)2型LOS患者在VCE期间出现声带麻痹(VCP) (p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The use of thyroid cartilage needle electrodes during intra-operative nerve monitoring in thyroid surgery: A multi-center retrospective study.

In previous studies, the use of thyroid cartilage needle electrodes (TCN) was defined as an inexpensive method for intra-operative nerve monitoring (IONM) in thyroid surgery. This multi-center retrospective study aims to determine the effectiveness and reliability of TCN in thyroid surgery. Patients operated on between January 2018 and August 2023 from five centers were included in this study. Demographic data, indications, type of surgery, IONM recording system, pre-post-resection vagus nerve (V1-V2), pre-post-resection recurrent laryngeal nerve (R1-R2) amplitudes and latency values, type of loss of signal (LOS), adverse event (AE), intra-operative injury mechanism, and post-operative vocal cord examination (VCE) were evaluated. Patients with abnormal preoperative vocal cord examination were excluded. A total of 2105 patients (3772 nerves at risk) were included [1626 (77%) female, 479 (23%) male]; within this study, 1112 patients (53%) received a diagnosis of malignancy, while 993 (47%) were diagnosed with benign conditions. The mean initial vagus amplitude was 1093.74 µV (± 861.39). LOS occurred in 63 patients [Type 1 (84%), Type 2 (16%)] and AE in 36. No false-positive LOS occurred. Forty-six (87%) of LOS type 1 patients and nine (90%) of LOS type 2 patients had vocal cord palsy (VCP) during VCE (p < 0.05). In AE patients, there were only two (5.5%) patients who had vocal cord palsy during VCE (p < 0.05). VCP occurred in 57(2.7%) patients, with 9 (0.42%) remaining permanent. TCN is an inexpensive and feasible alternative to endotracheal tube electrodes and a system with satisfying amplitudes. It can also precisely predict post-operative vocal cord functions.

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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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