Segurança na cirurgia da tiróide: neuromonitorização e selagem vascular

Luis Miguel Torres Morientes; Eduardo Tamayo Gómez; Liliana Filipa  Invencio da Costa; Marta Alonso Mesonero; María San Millán González; Jaime Santos Pérez

doi:10.34631/sporl.2167

Autores

Luis Miguel Torres Morientes ENT Department Clinical University Hospital of Valladolid, Spain https://orcid.org/0000-0003-3689-5320
Eduardo Tamayo Gómez Department of Anesthesiology and Critical Care, Clinical University Hospital of Valladolid, Valladolid, Spain; Department of Surgery, Faculty of Medicine, University of Valladolid, Valladolid, Spain; BioCritic, Biomedical Research Group in Critical Care, Valladolid, Spain; Biomedical Research Networking Centre on Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain https://orcid.org/0000-0001-8900-0944
Liliana Filipa Invencio da Costa ENT Department Clinical University Hospital of Valladolid, Spain https://orcid.org/0000-0003-3500-6472
Marta Alonso Mesonero ENT Department Clinical University Hospital of Valladolid, Spain https://orcid.org/0000-0001-8507-9421
María San Millán González ENT Department Clinical University Hospital of Valladolid, Spain https://orcid.org/0000-0003-4894-613X
Jaime Santos Pérez ENT Department Clinical University Hospital of Valladolid, Spain https://orcid.org/0000-0002-0423-9241

DOI:

https://doi.org/10.34631/sporl.2167

Palavras-chave:

Neuromonitoring, thyroidectomy, vascular sealing, hemostasis

Resumo

Introduction: Thyroid surgery carries significant risks and complications such as recurrent laryngeal nerve paralysis and postoperative suffocating hematoma. The most recent advancement providing safety is intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) and the advances in hemostasis systems.

Objective: The main objective of the study was to explore our experience regarding safety measures and the reduction of complications in thyroid surgery.

Materials and Methods: We present a review of 400 neck surgeries performed by the same surgeon, from September 2011 to February 2020. The main variables studied were intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve and vascular sealing hemostasis systems.
Results: Out of the total 400 patients, a total of 625 RLNs were studied, using IONM. Thirteen unilateral vocal cord paralyses were recorded, 8 of which were temporary and only 5 definitive. The predominant hemostasis system utilized was the vascular sealing system and bipolar clamp 87%, and in 13%, ligation of a thyroid artery. Only 1 patient experienced postoperative hemorrhage, which was resolved without incidents.

Conclusions: Intermittent intraoperative neuromonitoring of the RLN and advances in hemostasis systems have proven to be valuable in thyroid surgery, improving safety and saving surgical time.

Referências

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Segurança na cirurgia da tiróide: neuromonitorização e selagem vascular

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