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Article: Feasibility on the use of intraoperative vagal nerve stimulation in gasless, transaxillary endoscopic, and robotic-assisted thyroidectomy

TitleFeasibility on the use of intraoperative vagal nerve stimulation in gasless, transaxillary endoscopic, and robotic-assisted thyroidectomy
Authors
Issue Date2011
PublisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/lap
Citation
Journal of Laparoendoscopic & Advanced Surgical Techniques, 2011, v. 21 n. 10, p. 911-917 How to Cite?
AbstractBACKGROUND: Intraoperative nerve stimulation (IONS) could potentially reduce the incidence of recurrent laryngeal nerve (RLN) injury in thyroidectomy. The current study aimed at demonstrating the technical feasibility of using IONS in gasless, transaxillary endoscopic thyroidectomy (GTET) and robotic-assisted thyroidectomy (RAT) with conventional nerve stimulator probe and comparing the overall accuracy between two different nerve stimulation techniques, namely the direct RLN stimulation and the indirect stimulation via the vagus nerve (VN group), in predicting postoperative RLN function. METHODS: From 2009 to 2010, 60 (17.1%) patients underwent endoscopic thyroidectomy using IONS. Thirty-three (55.0%) patients had direct intraoperative RLN stimulation (RLN group), whereas 27 (45.0%) patients had stimulation to the VN (VN group). Total number of nerves at risk was 76. The results of IONS were confirmed by the postoperative vocal cord movement on laryngoscopy. RESULTS: Patient demographics, surgical indications, resection type, size of dominant nodule, excised gland weight, and final pathology were similar between the two groups. The number of vocal cord palsies in the RLN and VN groups was 3 (7.3%) and 2 (5.7%), respectively. Compared with the VN group, the RLN group had a significantly lower percentage of true negatives (78.0% vs. 94.3%, P=.045) and higher percentage of false positives (14.6% vs. 0.0%, P=.018). Overall accuracy was higher in the VN group. CONCLUSIONS: The current study demonstrated the technical feasibility of using conventional open-nerve stimulator probe in both GTET and RAT. Indirect stimulation via the VN produced more reliable and accurate IONS test results than direct RLN stimulation.
Persistent Identifierhttp://hdl.handle.net/10722/192055
ISSN
2015 Impact Factor: 1.297
2015 SCImago Journal Rankings: 0.680
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLang, BHH-
dc.contributor.authorWong, KP-
dc.date.accessioned2013-10-16T08:17:25Z-
dc.date.available2013-10-16T08:17:25Z-
dc.date.issued2011-
dc.identifier.citationJournal of Laparoendoscopic & Advanced Surgical Techniques, 2011, v. 21 n. 10, p. 911-917-
dc.identifier.issn1092-6429-
dc.identifier.urihttp://hdl.handle.net/10722/192055-
dc.description.abstractBACKGROUND: Intraoperative nerve stimulation (IONS) could potentially reduce the incidence of recurrent laryngeal nerve (RLN) injury in thyroidectomy. The current study aimed at demonstrating the technical feasibility of using IONS in gasless, transaxillary endoscopic thyroidectomy (GTET) and robotic-assisted thyroidectomy (RAT) with conventional nerve stimulator probe and comparing the overall accuracy between two different nerve stimulation techniques, namely the direct RLN stimulation and the indirect stimulation via the vagus nerve (VN group), in predicting postoperative RLN function. METHODS: From 2009 to 2010, 60 (17.1%) patients underwent endoscopic thyroidectomy using IONS. Thirty-three (55.0%) patients had direct intraoperative RLN stimulation (RLN group), whereas 27 (45.0%) patients had stimulation to the VN (VN group). Total number of nerves at risk was 76. The results of IONS were confirmed by the postoperative vocal cord movement on laryngoscopy. RESULTS: Patient demographics, surgical indications, resection type, size of dominant nodule, excised gland weight, and final pathology were similar between the two groups. The number of vocal cord palsies in the RLN and VN groups was 3 (7.3%) and 2 (5.7%), respectively. Compared with the VN group, the RLN group had a significantly lower percentage of true negatives (78.0% vs. 94.3%, P=.045) and higher percentage of false positives (14.6% vs. 0.0%, P=.018). Overall accuracy was higher in the VN group. CONCLUSIONS: The current study demonstrated the technical feasibility of using conventional open-nerve stimulator probe in both GTET and RAT. Indirect stimulation via the VN produced more reliable and accurate IONS test results than direct RLN stimulation.-
dc.languageeng-
dc.publisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/lap-
dc.relation.ispartofJournal of Laparoendoscopic & Advanced Surgical Techniques-
dc.rightsThis is a copy of an article published in the Journal of Laparoendoscopic & Advanced Surgical Techniques © 2011 [copyright Mary Ann Liebert, Inc.]; Journal of Laparoendoscopic & Advanced Surgical Techniques is available online at: http://www.liebertonline.com.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshEndoscopy-
dc.subject.meshMonitoring, Intraoperative - methods-
dc.subject.meshRobotics-
dc.subject.meshThyroidectomy - methods-
dc.subject.meshVagus Nerve Stimulation-
dc.titleFeasibility on the use of intraoperative vagal nerve stimulation in gasless, transaxillary endoscopic, and robotic-assisted thyroidectomyen_US
dc.typeArticleen_US
dc.identifier.emailLang, BHH: blang@hkucc.hku.hk-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1089/lap.2011.0204-
dc.identifier.pmid22011275-
dc.identifier.scopuseid_2-s2.0-82455220975-
dc.identifier.hkuros197740-
dc.identifier.volume21-
dc.identifier.issue10-
dc.identifier.spage911-
dc.identifier.epage917-
dc.identifier.isiWOS:000298138800005-
dc.publisher.placeUnited States-

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