Open AccessEfficacy of intraoperative recurrent laryngeal neuromonitoring during surgery for esophageal cancer
Author(s) -
Takeda Shigeru,
Iida Michihisa,
Kanekiyo Shinsuke,
Nishiyama Mitsuo,
Tokumitsu Yukio,
Shindo Yoshitaro,
Yoshida Shin,
Suzuki Nobuaki,
Yoshino Shigefumi,
Nagano Hiroaki
Publication year - 2021
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12394
Subject(s) - medicine , recurrent laryngeal nerve , surgery , palsy , anesthesia , paralysis , incidence (geometry) , thyroid , physics , alternative medicine , pathology , optics
Aim To evaluate the efficacy of intraoperative neuromonitoring in identifying recurrent laryngeal nerves and decreasing the incidence of nerve injury in minimally invasive esophagectomies for esophageal cancers. Methods A total of 167 minimally invasive esophagectomy patients were retrospectively reviewed. They were divided into intraoperative neuromonitoring (n = 84) and no intraoperative neuromonitoring (n = 83) groups, based on whether or not intraoperative neuromonitoring was used during surgery. We compared short‐term surgical outcomes and incidence of recurrent laryngeal nerve palsy between the two groups before and after propensity score matching. The association between the loss of signal and recurrent laryngeal nerve palsy was also evaluated. Results The incidence of recurrent laryngeal nerve palsy (grade 2 and higher) was lower in the intraoperative neuromonitoring group than in the no intraoperative neuromonitoring group (6.0% vs 21.2%, P = 0.02). The rate of recurrent laryngeal nerve palsy recovery within 6 months was also significantly higher in the intraoperative neuromonitoring group (87.5% vs 20.0%, P < 0.01). The positive and negative predictive values of intraoperative neuromonitoring for recurrent laryngeal nerve palsy were 60% (9/15) and 86.9% (60/69), respectively. The duration from paralysis to recovery was shorter in recurrent laryngeal nerve palsy cases with negative loss of signal results than in cases with positive loss of signal results (median: 43 days vs 95 days). Conclusion Intraoperative neuromonitoring is useful in identifying recurrent laryngeal nerves and may aid in reducing the incidence of recurrent laryngeal nerve injury during esophageal surgery.