Nerve monitoring decreases recurrent laryngeal nerve injury risk for neoplasm-related thyroidectomy

Duong, William; Grigorian, Areg; Farzaneh, Cyrus; Elfenbein, Dawn M.; Yamamoto, Maki; Rosenbaum, Kathryn; Lekawa, Michael; Nahmias, Jeffry

doi:10.1016/j.amjsurg.2021.10.013

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…This finding was not unexpected since if it occurs, it is likely almost entirely related to iatrogenic factors or tumor factors 34 . Operative techniques, such as the use of neuromonitoring, could be a potential confounder, which is not known in the database 35 . Rates of mortality, sepsis, tracheostomy, and respiratory dependence were higher in patients with hypoalbuminemia, but could not be compared because of 1 cohort having a n ≤ 10.…”

Section: Discussionmentioning

confidence: 98%

“… 34 Operative techniques, such as the use of neuromonitoring, could be a potential confounder, which is not known in the database. 35 Rates of mortality, sepsis, tracheostomy, and respiratory dependence were higher in patients with hypoalbuminemia, but could not be compared because of 1 cohort having a n ≤ 10. An increased risk of sepsis has been observed in hypoalbuminemia patients who underwent parathyroidectomy.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Serum Albumin as Predictor of Outcomes After Thyroidectomy

Sciscent,

Eberly,

Lorenz

et al. 2024

OTO Open

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ObjectiveAlbumin is considered to be a surrogate marker for inflammation and nutritional status. Levels usually decrease after surgery but little is known about the predictive value of preoperative albumin levels in patients undergoing thyroidectomy. This study aimed to investigate the 30‐day incidence of postoperative outcomes in thyroidectomy patients with and without preoperative hypoalbuminemia.Study DesignRetrospective cohort study.SettingTriNetX Database.MethodsTriNetX, a federated deidentified database, was retrospectively queried to identify patients who underwent thyroidectomy. Postoperative outcomes within 30 days of thyroidectomy, based on International Classification of Disease, 10th Revision and Current Procedural Terminology codes, in patients with preoperative hypoalbuminemia (≤3.4 g/dL) (cohort 1) were analyzed and compared to patients without hypoalbuminemia (cohort 2).ResultsAfter propensity score matching, 2398 patients were identified in each cohort. Hypoalbuminemia patients were more likely to have postoperative pneumonia (odds ratio, OR: 3.472, 95% confidence interval, CI [2.016‐5.978]), acute renal failure (OR: 3.872, 95% CI [2.412‐6.217]), venous thromboembolism (OR: 1.766, 95% CI [1.016‐2.819]), and surgical site infection (OR: 2.353, 95% CI [1.282‐4.32]). Rates of recurrent laryngeal nerve injury were comparable between cohorts.ConclusionPatients undergoing thyroidectomy with preoperative hypoalbuminemia have a higher prevalence of postoperative complications compared to patients without preoperative hypoalbuminemia. While not routinely assessed, preoperative evaluation of serum albumin levels may help guide expectations and optimal management of thyroidectomy patients.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Preoperative Serum Albumin as Predictor of Outcomes After Thyroidectomy

Sciscent,

Eberly,

Lorenz

et al. 2024

OTO Open

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“…The actual usefulness of I-IONM is still a matter of debate in the literature. Some authors suggest that routine I-IONM does not decrease unilateral RLN injuries, both transient and permanent, compared with visualization alone [90,91,98], while others report a lower incidence of transient vocal cord paralysis following RLN injury when I-IONM is utilized, particularly in high-risk surgery, such as reinterventions and advanced thyroid cancers [99][100][101]. As reported by Barczyński et al [102] in 2011, the use of IONM in thyroid cancer surgery decreased the risk of RLN injury by 3.7%, including a 3% drop in the risk of transient damage and a 0.7% drop in the risk of permanent damage.…”

Section: Ionm Can Be Distinguished Into Intermittent (I-ionm) and Con...mentioning

confidence: 99%

Technological Innovations in Thyroid Cancer Surgery

Cappellacci¹,

Canu²,

Piras³

et al. 2022

Oncologie

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Thyroid cancer is the fifth most common cancer in the USA, with differentiated subtype accounting for more than 95% of neoplasm. Surgery remains the mainstay of treatment, either with lobectomy or total thyroidectomy. In the last decades, many technological innovations have been introduced in this field. The aim of this review is to illustrate the most recent advances regarding the classical surgical approach, particularly regarding hemostatic devices, parathyroid identification with fluorescence systems, intraoperative identification of lymph node metastases, and intraoperative neuromonitoring.

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