Evaluation of the Learning Curve for Intraoperative Neural Monitoring of the Recurrent Laryngeal Nerves in Thyroid Surgery*
Journal Title: Polish Journal of Surgery - Year 2014, Vol 86, Issue 12
Abstract
Intraoperative neuromonitoring facilitates identification of the recurrent laryngeal nerves (RLN) and allows for predicting their postoperative function. Nevertheless, the outcome of thyroid surgery monitoring is affected by both the experience of the operator and his mastering of the technique. The aim of the study was the assessment of the learning curve for intraoperative RLN neuromonitoring. Material and methods. The prospective analysis included 100 consecutive thyroid operations performed by a single surgeon during implementation of RLN neuromonitoring in a district surgical ward in Staszów. RLN neuromonitoring was performed in keeping with the recommendations of the International Neural Monitoring Study Group using a C2 NerveMonitor (Inomed, Germany). The outcomes of initial 50 procedures (group I: 08/2012-07/2013) were compared with the results of subsequent 50 operations (group II: 08/2013-07/2014). The evaluation included demographic and intraoperative data along with predictive value of the method and complications. Results. In group II as compared to group I, a significant reduction of operative time was noted (102.1±19.4 vs 109.9±19; p=0.045), along with an increased percentage of identified RLNs (99% vs 89.2%; p=0.006), a decreased percentage of correction-requiring technical errors (8% vs 24%; p=0.029), an improved negative predictive (99% vs 89.3%; p<0.001) and positive value (75% vs 55.6%; p<0.001), as well as a decreased percentage of RLN injuries (3% vs 14%; p=0.006). Conclusions. Mastering the technique of intraoperative RLN neuromonitoring in thyroid surgery requires the surgeon to perform independently approximately 50 monitored procedures, what allows for achieving the predictive value of the method that is comparable to outcomes published by referral centers.
Authors and Affiliations
Krzysztof Pragacz, Marcin Barczyński
Keywords
Related Articles
- EP ID EP74368
- DOI 10.1515/pjs-2015-0005
- Views 131
- Downloads 0
Surgical Procedures Not Connected with Transplantation in Patients After Kidney or Kidney and Pancreas Transplant with Stable Function of Graft
Infections in Notes
Giant epidermal cyst of the occipital area
Epidermal cyst is the most commonly observed cutaneous tumor. It usually involves the scalp, neck, face, back, and trunk. A commonly seen epidermal cyst is usually a slow-growing tumor of a diameter of 1-2 cm. Cysts with...
Choroba kociego pazura u 9-letniej pacjentki – opis przypadku
Choroba kociego pazura to zoonoza wywołana przez Gramm-ujemne bakterie Bartonalla henselae lub Bartonella qiuntana, na skutek zadrapania przez zwierzę-nosiciela, najczęściej kota. Choroba najczęściej początkowo przebiega...
Czynniki ryzyka i wskaźniki zapalne w nieszczelności zespolenia po całkowitym wycięciu mezorektum z wyłonieniem stomii
Cel: Celem badania jest analiza czynników związanych z nieszczelnością zespolenia (NZ) po niskiej resekcji przedniej i całkowitym wycięciu mezorektum (LAR-TME) oraz określenie przydatności wczesnego pomiaru białek C-reak...