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• W3130198238 abstract "Identification of recurrent laryngeal nerve (RLN), performed via different techniques, decreases nerve injury during thyroidectomy. We aimed to evaluate the effect of different anatomic levels at which RLN was identified on postoperative complications.The patients underwent total thyroidectomy or lobectomy without lymph node dissection were included. Two different surgical methods were performed: thyroidectomy identifying RLN at level of inferior thyroid artery (ITA) (Group 1); at level of Berry's ligament (Group 2). Patients were evaluated with indirect laryngoscopy on 3rd postoperative day, if nerve damage was determined, at each six months. Nerve damage and postop hypocalcemia were accepted transient up to 6th month, permanent after 6th month. Total serum calcium levels were postoperatively measured on 24th and 48th hours, and then monthly.Unilateral and bilateral RLN damage were detected as 4.4% and 2.2% in Group 1; and 8% and 2.67% in Group 2, respectively. The frequency of RLN damage was similar (p=0.62). Postoperative hypocalcemia was significantly higher in Group 1 (p=0.04); hypocalcemia was similar (p=0.149). One patient in Group 1, and 2 patients in Group 2 had f superior laryngeal nerve (SLN) injury. Three patients from each group showed permanent hypocalcemia. One patient in Group 1, and two in Group 2 developed permanent hoarseness.RLN injury was similar in both groups, however, temporary hypocalcemia was more frequent in patients undergone thyroidectomy with RLN identification at ITA level.Devascularization of parathyroid glands may be accused. Future studies are needed.Recurrent laryngeal nerve, Thyroidectomy.L’identificazione del nervo laringeo ricorrente (RLN), realizzata con metologie diverse riduce il rischio di un suo danneggiamento. A tale scopo abbiamo valutare la differenza di complicanze postoperatorie in relazione ai diversi livelli anatomici della sua identificazione. Sono stai inclusi nello studio i pazienti sottoposti a tiroidectomia totale o lobectomia senza dissezione linfonodale, e sono stati adottati due diversi metodi chirurgici: tiroidectomia con identificazione del RLN a livello dell’arteria tiroidea inferiore (ITA) (Gruppo 1) e quelli a livello del legamento di Berry (Gruppo 2). I pazienti sono stati valutati con laringoscopia indiretta il 3° giorno postoperatorio in caso di danno, e poi pgni sei mesi. Il danno nervoso e l’ipocalcemia postoperatoria sono stati definiti come transitori entro il sesto mese e permanenti dopo il 6° mese. I livelli totali di calcio nel siero sono stati misurati dopo l’intervento 24 e 48 ore e poi mensilmente. Il danno RLN unilaterale e bilaterale sono stati rispettivamente del 4,4% e del 2,2% nel gruppo 1; del 8% e del 2,67% nel gruppo 2. La frequenza del danno RLN è risultata statisticamente simile (p = 0,62). L’ipocalcemia postoperatoria è risultata significativamente più grave nel gruppo 1 (p = 0,04), analogamente è risultata clinicamente (p = 0,149). Un paziente del gruppo 1 e 2 pazienti del gruppo 2 hanno presentato una lesione del nervo laringeo (SLN) superiore. Tre pazienti di ciascun gruppo presentavano ipocalcemia permanente. Un paziente del gruppo 1 e due del gruppo 2 hanno sviluppato una raucedine permanente. In pratica la lesione RLN è risultata simile in entrambi i gruppi, tuttavia, l’ipocalcemia temporanea era più frequente nei pazienti sottoposti a tiroidectomia con identificazione RLN a livello ITA. In tal caso può essere chiamata in causa una devascolarizzazione delle ghiandole paratiroidi. Sono necessari ulteriori studi." @default.
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• W3130198238 date "2021-01-01" @default.
• W3130198238 modified "2023-09-29" @default.
• W3130198238 title "Identification of the recurrent laryngeal nerve during thyroidectomy can affect the complication rate." @default.
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