RECURRENT LARYNGEAL NERVES INJURY DURING THYROID SURGERY. Tiroid ameliyatlar?nda Nervus Rekürrens sinir yaralanmas?.

摘要

The technique of thyroidectomy has been in evolution for many years. It is a fundamental principle of surgery that a structure must be identified clearly during the procedure to prevent its damage. To evaluate our routine identification of the recurrent laryngeal nerves (RLNs) during thyroidectomy aiming lessen the inadvertent injury of the RLN during surgery. A convenience sample, non probability total coverage multicentre Hospital based descriptive prospective study (December 2009 to May 2012) included all patients managed by subtotal thyroidectomy after acceptance the informed consent. All operations were undertaken in both hospitals by the same surgical team. Data collected using a predesigned questionnaire. All thyroidectomies were evaluated, and the various types of recurrent laryngeal nerves were recorded. Data was analyzed using SPSS version 15.0. It included 82 patients [69 (84.15%) females and 13 (15.85%) males], with male to female ratio of 1:5.3. Their mean age was 42.8 years (SD±8.4 years). All were treated by subtotal thyroidectomy. The rate of identification of the RLN was 100% for all patients. The overall frequency of RLN injury was 1.2% seen in one patient. Study proved that surgical exposure of the RLNs avoids the incidence of its damage.??ZETTiroidektomi tekni?i y?llar i?erisinde de?i?im g?stermektedir. Cerrahiye ba?l? hasar?n ?nlenmesi i?in klasik olarak dokular?n tan?mlanmas? temel kurald?r. Sinir hasar?n? ?nlemek i?in ameliyatlar?m?z s?ras?nda Rekürrent laryngeal siniri rutin olarak tan?ml?yoruz. Aral?k 2009 ile May?s 2012 aras?nda subtotal tiroidektomi yapaca??m?z bütün hastalardan muvafakat alarak multisentrik bir ?al??ma ger?ekle?tirdik. Ameliyatlar iki hastanede de ayn? ekip taraf?ndan ger?ekle?tirildi. Veriler ?nceden belirlenmi? bir formata g?re topland?. Rekürrent laryngeal sinir tiplerine g?re veriler topland? ve SPSS 15.0 ile analiz edildi. 69’u erkek, 13’ü kad?n 82 hasta ?al??maya al?nd?. Erkek / kad?n oran? 1/5.3, ya? ortalamas? ise 42.8 y?l (SD±8.4 y?l) olarak saptand?. Rekürrent laryngeal sinir yaralanmas? %1.2 vakada g?rüldü. Sonu? olarak, rekürrent laryngeal sinirin ameliyatta g?rülmesinin yaralanma insidans?n? azaltt??? saptand?.