INCIDENCE OF RECURRENT LARYNGEAL NERVE PALSY IN CERVICAL ANASTOMOSIS AFTER ESOPHAGECTOMY FOR CARCINOMA ESOPHAGUS

Objective: To study the incidence of Recurrent Laryngeal Nerve Palsy (RLNP) in cervical anastomosis after esophagectomy for carcinoma of the esophagus. Study Design: Prospective observational study. Place and Duration of Study: Military Hospital’s Thoracic surgery departments, Combined Military Hospital Rawalpindi, Combined Military Hospital Lahore and Combined Military Hospital Multan, from Jan 2010 to Sep 2020. Methodology: Designated proformas were used to collect data. Histopathologically proven, operable cases of carcinoma esophagus with normal phonation were included, all of which underwent cervical anastomosis. All cases of benign pathologies and per-operative macroscopically advanced loco-regional disease were excluded. Recurrent laryngeal nerve (RLN) was identified in all cases and follow-up of 6 months for recovery period was executed. Results: 220 cases were included out of which 121 (55%) were males while 99 (45%) females. The age range was 14-81 years (mean is 38.7 ± 16.78). Out of 29 (13.6%) cases underwent minimally invasive esophagectomy (MIE) while thoracophreno laparotomy was performed in 100 (45.4%) cases, McKeown in 46 (20.9%) and Trans-hiatal esophagectomy (THE) in 45 (20.4%) patients. Recurrent Laryngeal Nerve Palsy was found in 19 patients (8.6%), tracheal injury in 3 (1.3%) and bronchial injury in 1 (0.4%) patient. Recurrent Laryngeal Nerve Palsy was transient in 14 cases and permanent damage persisted in 5 patients. Conclusion: Recurrent Laryngeal Nerve Palsy after esophagectomy is related to increased morbidity due to respiratory complications. With Sharp dissection technique, adequate surgical skill and equipment, the incidence of Recurrent Laryngeal Nerve Palsy can be decreased. In our study, it is less............

Download Full-text

Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽

10.1024/1023-9332.7.1.20 ◽

2001 ◽

Vol 7 (1) ◽

pp. 20-24 ◽

Cited By ~ 14

Author(s):

Robert ◽

Mariéthoz ◽

Pache ◽

Bertin ◽

Caulfield ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Palsy ◽

Recurrent Laryngeal Nerve Palsy ◽

Laryngeal Nerve ◽

Long Term Results ◽

Graves Disease ◽

Laryngeal Nerve Palsy ◽

Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

Download Full-text