A Strategy for Using Intraoperative Nerve Monitoring During Esophagectomy to Prevent Recurrent Laryngeal Nerve Palsy

There have been only sporadic reports on intraoperative nerve monitoring (IONM) during esophageal cancer surgery. We aimed to establish a strategy for the use of IONM during esophagectomy. Forty-one cases enrolled in this study. The IONM was performed before and after lymph node dissection in the th...

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Published inAnticancer research Vol. 38; no. 3; pp. 1563 - 1567
Main Authors Yuda, Masami, Nishikawa, Katsunori, Takahashi, Keita, Kurogochi, Takanori, Tanaka, Yujiro, Matsumoto, Akira, Tanishima, Yuichiro, Mitsumori, Norio, Yanaga, Katsuhiko
Format Journal Article
LanguageEnglish
Published Greece International Institute of Anticancer Research 01.03.2018
Subjects
Aged
Biopsy
Cancer
Cancer surgery
Esophageal cancer
Esophageal Neoplasms - surgery
Esophagectomy - methods
Esophagus
Feasibility Studies
Female
Humans
Lymph nodes
Male
Middle Aged
Monitoring
Monitoring, Intraoperative - methods
Nerves
Paralysis
Predictions
Recurrent Laryngeal Nerve - physiopathology
Reproducibility of Results
Surgery
Thorax
Vocal Cord Paralysis - diagnosis
Vocal Cord Paralysis - physiopathology
Vocal Cord Paralysis - prevention & control
vagus nerve
esophagectomy
recurrent laryngeal nerve
intraoperative nerve monitoring
Esophageal cancer
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Summary:There have been only sporadic reports on intraoperative nerve monitoring (IONM) during esophageal cancer surgery. We aimed to establish a strategy for the use of IONM during esophagectomy. Forty-one cases enrolled in this study. The IONM was performed before and after lymph node dissection in the thoracic cavity and cervical area. Occurrence of recurrent laryngeal nerve (RLN) palsy was assessed on the seventh postoperative day. The identification of nerves using IONM was possible in all cases. The positive and negative predictive values of IOMN were 80% and 92%, respectively. Loss of response was observed during the thoracic procedure in 14 out of 16 cases, with the predominance of left RLN palsy (n=12). In esophageal cancer surgery, identification of the RLN using IONM can be carried out safely, simply, and promptly. Using IONM systematically, the prediction of RLN palsy and detection of nerve injury point seems feasible.
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ISSN:0250-7005
1791-7530
DOI:10.21873/anticanres.12385