Cic edizioni internazionali
Il Giornale di Chirurgia

IONM and minimally invasive videoassisted thyroidectomy

Original Article, 291 - 296
doi: 10.11138/gchir/2018.39.5.291
Tag this article
Abstract
Full text PDF
Background. We know that benefits of MIVAT are related to a better cosmetic result and lower post-operative pain in comparison to CT. The incidence of nerve cold palsy is related to a correct identification of the recurrent laringeal nerve (RLN) as standard procedure in thyroid surgery. From September 2014 we have introduced the use of intraoperative neural monitoring(I-IONM) in all thyroidectomies in the Unit of General Surgery of University Hospital of Parma, including in MIVAT.
Patients and methods. We have considered all patients treated from September 2014 to September 2017 for thyroid diseases using MIVAT and IONM. Intermittent neuromonitoring with NIM-3.0 equipment (Medtronic, Jacksonville, FL, USA) was used during all
operations. We have recorded all data about age, sex, diagnosis, surgical time, i-IONM signal, postoperative pain, postoperative hypocalcemia after 24 hours, haematoma and vocal cord palsy. The mean hospital stay was collected from surgical procedure to hospital discharge. We have considered vocal dysfunctions that persist six months after surgery as permanent.
Results. From September 2014 to September 2017 we treated consecutively with both MIVAT and i-IONM 100 patients.
Considering the extent of surgery, 26 pts underwent to hemithyroidectomy and 74 pts to total thyroidectomy. The mean surgical time was 61.8 minutes. In 7 cases the patients were affected by preoperative clinical dysphonia. Using I-IONM during thyroidectomy, we recorded in 5 cases (5%) a loss of signal; in two cases (2%) we experienced a temporary postoperative vocal cord palsy.
Discussion. In our experience the use of IONM has improved the safety during thyroidectomy because precision that can be achieved by endoscopic procedures is further improved by complementary use of IONM. The costs associated to a potential reduction of medical litigation have not been investigated.

Vol. XL (No. 1) 2019 January - February

  1. Raffaele Bastianelli: Magister sine cathedra
    Di Matteo G.
  2. Thrombotic complications in inflammatory bowel diseases
    Fornaro R., Caristo G., Stratta E., Caratto M., Caratto E., Giovinazzo D., Di Maira L., Casaccia M., Frascio M.
  3. Early diagnosis of anastomotic leakage after colorectal surgery by the Dutch leakage score, serum procalcitonin and serum C-reactive protein: study protocol of a prospective multicentre observational study by the Italian ColoRectal Anastomotic Leakage (iC
    Benedetti M., Ciano P., Pergolini I., Ciotti S., Guercioni G., Ruffo G., Borghi F., Patriti A., Del Rio P., Scatizzi M., Mancini S., Garulli G., Carrara A., Pirozzi F., Scabini S., Liverani A., Baiocchi G., Campagnacci R., Muratore A., Longo G., Caricato M., Macarone Palmieri R., Vettoretto N., Caccaroni M., Guadagni S., Bertocchi E., Cianflocca D., Lambertini M., Pace U., Baraghini M., Pandolfini L., Angeloni R., Lucchi A., Martorelli G., Tirone G., Motter M., Sciuto A., Martino A., Luzzi A.P., Di Cesare T., Molfino S., Maurizi A., Marsanic P., Tomassini F., Santoni S., Capolupo G.T., Amodio P., Arici E., Clementi M., Ruggeri B., Catarci M.
  4. Open inguinal hernia repair with self-gripping Parietex ProGrip mesh: a retrospective study of 204 cases
    Del Papa M., D'Amata G., Manzi F., Carnì P., Florio G., Crovaro M., Musmeci L., Buonocore C.
  5. Use of the KSVM-based system for the definition, validation and identification of the incisional hernia recurrence risk factors
    Licari L., Salamone G., Campanella S., Carfì F., Fontana T., Falco N., Tutino R., De Marco P., Comelli A., Cerniglia D., Petrucci G., Vitabile S., Gulotta G.
  6. Colocutaneous fistula through ulcerative colitis and cancer to the pyoderma gangrenosum: a never-ending story for a single patient. Case report
    Eberspacher C., Mascagni D., Fralleone L., Maturo A., Di Matteo F.M., De Cristofaro F., Merletti D., Santoro A., Mascagni P., Pontone S., Pironi D.
  7. Amyand’s hernia: role of CT for a correct diagnosis
    Drago A., Carbone M., Lorusso V., Moschetta M., Scardapane A., Lucarelli N., Angelelli G., Stabile Ianora A.A.
  8. Modular megaprosthesis as definite treatment of femur osteomyelitis
    Koutserimpas C., Raptis K., Mari A., Kotsirakis A.
  9. Testicular torsion in a newborn: a case report
    Blevrakis E., Xenaki S., Chrysos E.
  10. Surveillance of pregnant women with potential exposure to Zika virus following travel
    Spiliopoulos D., Panchal M., Economides D.L.
  11. Mesenteric cyst and recurrent abdominal pain in a patient with Gorlin-Goltz syndrome: a case report
    Monaco L., Guida F., D'Onofrio G., Di Martino N.
  12. Squamous carcinoma in pilonidalis sinus: case report and review of literature
    Delvecchio A., Laforgia R., Sederino M.G., Minafra M., Carbotta G., Balducci G., Fabiano G., Fedele S., Palasciano N.
  13. congresses, academies, societies
    Di Matteo G.
Last Viewed articles: la lista degli ultimi x visitati.
  1. IONM and minimally invasive videoassisted thyroidectomy
    Del Rio P., Cozzani F., Nisi P.C., Loderer T., Piva G., Bonati E.
    doi: 10.11138/gchir/2018.39.5.291
credits