Use of U-shaped Retractor to Reduce Traction Injury of Recurrent Laryngeal Nerve in Video-assisted Thyroidectomy
10.3969/j.issn.1009-6604.2016.12.010
- VernacularTitle:U 型拉钩降低腔镜辅助甲状腺腺叶切除术的喉返神经牵拉损伤
- Author:
Jianye HE
;
Chenyu HE
- Keywords:
Recurrent laryngeal nerve;
Traction injury;
Video-assistance technology;
Papillary thyroid microcacinoma;
Retractor
- From:
Chinese Journal of Minimally Invasive Surgery
2016;16(12):1100-1102
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the home-made U-shaped retractor ’ s effect on reducing the traction injury of recurrent laryngeal nerve in the video-assistance thyroidectomy . Methods The patients with unilateral and unifocal papillary thyroid microcarcinoma , which were diagnosed by ultrasound preparation and by pathological postoperation , were enrolled .They all underwent the ipdilateral lobectomy , isthmus resection and the clearance of central lymph nodes with video-assistance technology .From January 2013 to June 2014, 79 cases ( control group ) were received conventional method , by which the thyroid lobe was elevated onto the trachea surface.From January 2015 to March 2016, 71 cases (U-shaped group) accepted the procedure which adopted home-made U-shaped retractor to pull the thyroid lobe to carotid artery horizontally .The operations were completed by the same surgeon .There were no significant differences between the two groups in age , gender and lesion size , which is comparable .The incidence rate of hoarseness was compared postoperation . Results Postoperative hoarseness of the U-shaped group occurred in 6 cases (8.5%) and the control group in 17 cases (21.5%), which show a significantly statistical difference (χ2 =4.919, P=0.027).And there was no significant difference in voice recovery time [median:16.5 d (8-31 d) vs.18 d (4-50 d), Z=-0.246, P=0.806]. Conclusion In the video-assisted thyroidectomy , using the U-shaped retractor to pull the thyroid lobe laterally and horizontally will be beneficial to reduce the recurrent laryngeal nerve tension and the incidence of the retract injury .
