Torky Radwan Abdelsabour, Abdel-Tawab Mohamed, Hussein Mohammed M
Department of Surgery, main hospital, Assiut Faculty of medicine, Assiut University, Assiut, Egypt.
Department of diagnostic and interventional radiology, main hospital, Assiut Faculty of medicine, Assiut University, Assiut, Egypt.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1974-1980. doi: 10.1007/s12070-023-03763-9. Epub 2023 Apr 21.
To evaluate the outcomes of the exposure versus non-exposure of the RLN during thyroidectomy for benign thyroid diseases.
A prospective study for patients who underwent thyroidectomy for benign diseases. They were classified into two groups, group 1 (the exposed group) and group 2 (the non-exposed group) of the RLN. History, examination, laboratory and radiological investigations as well as intra and post-operative details were recorded.
97 patients were included in the study, group 1 (63 patients) while group 2 (34 patients). The median age of both groups was 40 (for group 1) and 42 (for group 2) respectively. There was no significant difference regarding the gender of the patients (P = 0.089) and the type of surgery (P = 0.234). The duration of surgery as well as the amount of intraoperative blood loss were equal with no significant difference (P = 0.791) (P = 0.225). Hematoma was detected in three patients in the exposed group while RLN injury was detected in 5 patients in total (2 in group 1 and 3 in group 2) without any significant difference. There was significant hypocalcemia in favor of the non-exposed group (P = 0.001). Regarding the postoperative hospital stay, there was no significant difference between both groups (P = 0.720).
Exposure versus non-exposure of the RLN is still considered a matter of debate but precautions during dissection are a very useful maneuver. Meanwhile, it is better to expose the nerve with meticulous dissection and preservation of the parathyroid gland vascularity.
评估在良性甲状腺疾病甲状腺切除术中显露与不显露喉返神经（RLN）的结果。
对接受良性疾病甲状腺切除术的患者进行一项前瞻性研究。他们被分为两组，即RLN显露组（第1组）和RLN未显露组（第2组）。记录病史、检查、实验室及影像学检查结果以及术中和术后的详细情况。
97例患者纳入研究，第1组63例，第2组34例。两组的中位年龄分别为40岁（第1组）和42岁（第2组）。患者性别（P = 0.089）和手术类型（P = 0.234）方面无显著差异。手术时间以及术中失血量相当，无显著差异（P = 0.791）（P = 0.225）。显露组有3例患者出现血肿，总共5例患者发生RLN损伤（第1组2例，第2组3例），无显著差异。未显露组有明显的低钙血症（P = 0.001）。关于术后住院时间，两组之间无显著差异（P = 0.720）。
RLN显露与否仍存在争议，但解剖过程中的预防措施是非常有用的操作。同时，最好通过细致解剖并保留甲状旁腺血管来显露神经。
