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Article: A Prospective Study Evaluating the Feasibility and Accuracy of Post-operative Laryngeal Ultrasonography (LUSG) in Assessment of Vocal Cord Function After Esophagectomy

TitleA Prospective Study Evaluating the Feasibility and Accuracy of Post-operative Laryngeal Ultrasonography (LUSG) in Assessment of Vocal Cord Function After Esophagectomy
Authors
Issue Date2023
Citation
World Journal of Surgery, 2023, v. 47, n. 11, p. 2792-2799 How to Cite?
AbstractBackground: Vocal cord paresis (VCP) is a serious complication after esophagectomy. Conventional diagnosis of VCP relies on flexible laryngoscopy (FL), which is invasive. Laryngeal ultrasonography (LUSG) is non-invasive and convenient. It has provided accurate VC evaluation after thyroidectomy but it is unclear if it is just as accurate following esophagectomy. This prospective study evaluated the feasibility and accuracy of LUSG in VC assessment on day-1 after esophagectomy. Methods: Consecutive patients from a tertiary teaching hospital who underwent elective esophagectomy were prospectively recruited. All received pre-operative FL, and post-operative LUSG and FL on Day-1, each performed by a blinded, independent assessor. The primary outcomes were feasibility and accuracy of LUSG in the diagnosis of VCP on Day-1 post-esophagectomy. The accuracy of voice assessment (VA) was analyzed. Results: Twenty-six patients were eligible for analysis. The median age was 70 years (66–73). Majority were male (84.6%). Twenty-five (96.2%) received three-phase esophagectomy. Twenty-four (96%) had same-stage anastomosis at the neck. Three (11.5%) developed temporary and one (3.8%) developed permanent unilateral VCP. Overall VC visualization rate by LUSG was 100%; sensitivity, specificity, positive predictive value, negative predictive value (NPV) and accuracy of LUSG were 75.0%, 100%, 100%, 98.0%, 98.1% respectively, and superior to VA. Combining LUSG with VA findings could pick up all VCPs i.e. improved sensitivity and NPV to 100%. Conclusion: LUSG is a highly feasible, accurate and non-invasive method to evaluate VC function early after esophagectomy. Post-operative FL may be avoided in patients with both normal LUSG and voice.
Persistent Identifierhttp://hdl.handle.net/10722/336928
ISSN
2023 Impact Factor: 2.3
2023 SCImago Journal Rankings: 0.772
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFung, Matrix Man Him-
dc.contributor.authorWong, Ian Yu hong-
dc.contributor.authorChan, Fion Siu Yin-
dc.contributor.authorLaw, Tsz Ting-
dc.contributor.authorChan, Kwan Kit-
dc.contributor.authorWong, Claudia Lai Yin-
dc.contributor.authorLaw, Simon Ying Kit-
dc.contributor.authorLang, Brian Hung Hin-
dc.date.accessioned2024-02-29T06:57:30Z-
dc.date.available2024-02-29T06:57:30Z-
dc.date.issued2023-
dc.identifier.citationWorld Journal of Surgery, 2023, v. 47, n. 11, p. 2792-2799-
dc.identifier.issn0364-2313-
dc.identifier.urihttp://hdl.handle.net/10722/336928-
dc.description.abstractBackground: Vocal cord paresis (VCP) is a serious complication after esophagectomy. Conventional diagnosis of VCP relies on flexible laryngoscopy (FL), which is invasive. Laryngeal ultrasonography (LUSG) is non-invasive and convenient. It has provided accurate VC evaluation after thyroidectomy but it is unclear if it is just as accurate following esophagectomy. This prospective study evaluated the feasibility and accuracy of LUSG in VC assessment on day-1 after esophagectomy. Methods: Consecutive patients from a tertiary teaching hospital who underwent elective esophagectomy were prospectively recruited. All received pre-operative FL, and post-operative LUSG and FL on Day-1, each performed by a blinded, independent assessor. The primary outcomes were feasibility and accuracy of LUSG in the diagnosis of VCP on Day-1 post-esophagectomy. The accuracy of voice assessment (VA) was analyzed. Results: Twenty-six patients were eligible for analysis. The median age was 70 years (66–73). Majority were male (84.6%). Twenty-five (96.2%) received three-phase esophagectomy. Twenty-four (96%) had same-stage anastomosis at the neck. Three (11.5%) developed temporary and one (3.8%) developed permanent unilateral VCP. Overall VC visualization rate by LUSG was 100%; sensitivity, specificity, positive predictive value, negative predictive value (NPV) and accuracy of LUSG were 75.0%, 100%, 100%, 98.0%, 98.1% respectively, and superior to VA. Combining LUSG with VA findings could pick up all VCPs i.e. improved sensitivity and NPV to 100%. Conclusion: LUSG is a highly feasible, accurate and non-invasive method to evaluate VC function early after esophagectomy. Post-operative FL may be avoided in patients with both normal LUSG and voice.-
dc.languageeng-
dc.relation.ispartofWorld Journal of Surgery-
dc.titleA Prospective Study Evaluating the Feasibility and Accuracy of Post-operative Laryngeal Ultrasonography (LUSG) in Assessment of Vocal Cord Function After Esophagectomy-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00268-023-07128-9-
dc.identifier.pmid37540267-
dc.identifier.scopuseid_2-s2.0-85166912472-
dc.identifier.volume47-
dc.identifier.issue11-
dc.identifier.spage2792-
dc.identifier.epage2799-
dc.identifier.eissn1432-2323-
dc.identifier.isiWOS:001042459100003-

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