| アブストラクト | BACKGROUND: Lymphadenectomy around the recurrent laryngeal nerve (RLN) is an essential part of curative surgery for esophageal cancer. Although several single-center studies have shown that intraoperative nerve monitoring (IONM) can avoid RLN palsy, this has not been confirmed in a large-scale multicenter study. This study used a national database to evaluate whether IONM can reduce postoperative RLN palsy during minimally invasive esophagectomy (MIE) for esophageal cancer. METHODS: We retrieved data of patients with esophageal cancer who underwent 3-field thoracoscopic or robotic MIE with cervical anastomosis with IONM(+) (502 patients) and without IONM(-) (4353 patients) from April 2020 to March 2022 from the Diagnosis Procedure Combination database in Japan. We used propensity score-matching analysis to compare the frequency of postoperative RLN palsy and respiratory complications between the IONM(+) group and IONM(-) group. RESULTS: The postoperative RLN palsy rate was significantly lower in the IONM(+) than IONM(-) group (odds ratio, 0.24; 95% CI, 0.13-0.46). The respiratory complication rate was also significantly lower in the IONM(+) than in the IONM(-) group (odds ratio, 0.66; 95% CI, 0.45-0.97). The anesthesia time was significantly longer in the IONM(+) group (regression coefficient, 60.1 minutes; 95% CI, 44.2-76.9 minutes). The length of postoperative hospitalization tended to be shorter in the IONM(+) than in the IONM(-) group (regression coefficient, -1.39 days; 95% CI, -3.91 to 1.14). CONCLUSIONS: This national cohort study showed that IONM during 3-field MIE for esophageal cancer was associated with a reduction of postoperative RLN palsy and respiratory complications. |
|---|
| ジャーナル名 | The Annals of thoracic surgery |
|---|
| 投稿日 | 2024/8/13 |
|---|
| 投稿者 | Shigeno, Takashi; Okuno, Keisuke; Ogo, Taichi; Fujiwara, Hisashi; Tanioka, Toshiro; Kawada, Kenro; Haruki, Shigeo; Tokunaga, Masanori; Fushimi, Kiyohide; Kinugasa, Yusuke |
|---|
| 組織名 | Department of Gastrointestinal Surgery, Tokyo Medical and Dental University,;Tokyo, Japan.;Tokyo, Japan. Electronic address: oku-srg1@tmd.ac.jp.;Department of Health Policy and Informatics, Tokyo Medical and Dental University, |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39134234/ |
|---|
