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Autoren: Staubitz, Julia
Sluis, P. C. van der
Berlth, F.
Watzka, F.
Dette, F.
Läßig, A.
Lang, H.
Musholt, T. J.
Grimminger, Peter P.
Titel: Recurrent laryngeal nerve monitoring during totally robot-assisted Ivor Lewis esophagectomy
Online-Publikationsdatum: 3-Mai-2021
Sprache des Dokuments: Englisch
Zusammenfassung/Abstract: PURPOSE The robot-assisted approach for Ivor Lewis esophagectomy offers an enlarged, three-dimensional overview of the intraoperative situs. The vagal nerve (VN) can easily be detected, preserved, and intentionally resected below the separation point of the recurrent laryngeal nerve (RLN). However, postoperative vocal cord paresis can result from vagal or RLN injury during radical lymph node dissection, presenting a challenge to the operating surgeon. METHODS From May to August 2019, 10 cases of robot-assisted minimally invasive esophagectomy (RAMIE) with extended 2-field lymphadenectomy, performed at the University Medical Center Mainz, were included in a prospective cohort study. Bilateral intermittent intraoperative nerve monitoring (IONM) of the RLN and VN was performed, including pre- and postoperative laryngoscopy assessment. RESULTS Reliable mean signals of the right VN (2.57 mV/4.50 ms) and the RLN (left 1.24 mV/3.71 ms, right 0.85 mV/3.56 ms) were obtained. IONM facilitated the identification of the exact height of separation of the right RLN from the VN. There were no cases of permanent postoperative vocal paresis. Median lymph node count from the paratracheal stations was 5 lymph nodes. CONCLUSION IONM was feasible during RAMIE. The intraoperative identification of the RLN location contributed to the accuracy of lymph node dissection of the paratracheal lymph node stations. RLN damage and subsequent postoperative vocal cord paresis can potentially be prevented by IONM.
DDC-Sachgruppe: 610 Medizin
610 Medical sciences
Veröffentlichende Institution: Johannes Gutenberg-Universität Mainz
Organisationseinheit: FB 04 Medizin
Veröffentlichungsort: Mainz
DOI: http://doi.org/10.25358/openscience-5822
Version: Published version
Publikationstyp: Zeitschriftenaufsatz
Nutzungsrechte: CC BY
Informationen zu den Nutzungsrechten: https://creativecommons.org/licenses/by/4.0/
Zeitschrift: Langenbeck's archives of surgery
405
Seitenzahl oder Artikelnummer: 1091
1099
Verlag: Springer
Verlagsort: Berlin u.a.
Erscheinungsdatum: 2020
ISSN: 1435-2451
URL der Originalveröffentlichung: https://doi.org/10.1007/s00423-020-01990-0
DOI der Originalveröffentlichung: 10.1007/s00423-020-01990-0
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