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Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation

机译:颈部手术中的手术错误和并发症的法医学意义:基于意大利现行法规的评论

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摘要

Aim of the present paper is the review of the principal complications associated to endocrine neck surgery considering how expertise, full adoption of guidelines, appropriate technology and proper informed consent may limit the medicolegal claims at the light of the incoming new regulation of the medical professional legal responsibility. A literature search, using the Medline/PubMed database for full-length papers, was used. Postoperative recurrent laryngeal nerve (RLN) palsy and hypoparathy-roidism remain the principal causes of surgical malpractice claims . In the procedure of neck lymphadenctomy intra-operative haemorrhage, thoracic duct injury, injuries to loco-regional nerves can be observed and can be source of claims. After many years of increased medicolegal litigations, the Italian government is proposing a drastic change in the regulations of supposed medical malpractice in order to guarantee the patient’s right to a safe treatment and in the meantime to defend clinicians from often unmotivated and prejudicial legal cases. Surgical errors and complications in neck surgery are a relevant clinical issue. Only the combination of surgical and clinical expertise, application of guidelines, appropriate technology and a routinely use of specific informed consent can contain potential medicolegal implications.
机译:本文的目的是回顾与内分泌颈部手术相关的主要并发症,考虑到专业知识,充分采用指南,适当的技术和适当的知情同意可能如何根据即将到来的医学专业法新规定来限制医学上的合法性责任。文献检索使用Medline / PubMed数据库获取全文。术后喉返神经麻痹和甲状旁腺机能减退仍然是引起手术失当的主要原因。在颈部淋巴结清扫术中术中出血,胸导管损伤,局部区域神经损伤的过程中,可以观察到这种情况,并且可以作为索赔的来源。在经历了越来越多的法医学诉讼之后,意大利政府提议对假定的医疗事故法规进行大刀阔斧的修改,以保障患者享有安全治疗的权利,同时为临床医生辩护,使其免受经常毫无动机且有偏见的法律案件的侵害。颈部手术中的手术错误和并发症是一个相关的临床问题。只有外科和临床专业知识,指南的应用,适当的技术以及常规使用特定知情同意的组合,才能包含潜在的法医学意义。

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