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Cirugía paraguaya

versión On-line ISSN 2307-0420

Resumen

RODRIGUEZ-CUBILLA, Rodrigo Adrian. Thyroidectomy with neuromonitorizationof the recurrent nerve. Cir. parag. [online]. 2019, vol.43, n.3, pp.19-23. ISSN 2307-0420.  https://doi.org/10.18004/sopaci.2019.diciembre.19-23.

Neuromonitoring is an innovative method that is used during thyroidectomy to help localize the recurrent laryngeal nerve and its function. General objectives: To describe the experience in neuromonitoring of the recurrent laryngeal nerve in thyroidectomies. Specific objectives: Describe the times of neuromonitoring. Describe the equipment used for neuromonitoring. State advantages and disadvantages of the method. Evidence the age range of patients in the study. Determine the most frequent pathologies in the patients in the study. Evidence the prevalent sex of the patients studied. Determine the surgical technique classified in the cases studied. - Methodology: Design Observational cross-sectional observational study. Focused population: Patients operated on for thyroidectomy with recurrent laryngeal neuromonitoring in the period from June to October 2018 in 3 hospital centers. Materials and methods: An article search was done with the words "thyroidectomy", "neuromonitoring", "recurrent laryngeal nerve" in Pubmed (https://www.ncbi.nlm.nih.gov/pubmed); in the Cochrane Library (https://www.cochrane.org/); Scopus (https://www.scopus.com/home.uri); in google scholar (https://scholar.google.com/); cicco (http://www.cicco.org.py/) and Epistemonikos (www.epistemonikos.org).Clinical histories of thyroidectomized patients with use of neuromonitoring of the recurrent laryngeal nerve of 3 hospitals.Microsoft Word and Microsoft Excel program.Non-probabilistic sampling of consecutive cases. Study variables: Age, Sex, Diagnosis, Identification of the laryngeal nerve, Surgery performed, Postoperative complications. Conclusion: Currently, in Paraguay there is still a small number of cases of thyroidectomy with neuromonitoring of the recurrent laryngeal, since it is a method recently incorporated in our environment, but so far, good results. The technique of neuromonitoring begins in the pre-surgical. With the laryngoscopy, the preparation of the neuromonitoring equipment, the anesthetic technique and the appropriate position of the patient and the neuromonitoring itself. The use of our experience is the MEDTRONIC NIM 3.0 that consists of a monitor, connectors, electrodes, endotracheal tube and hand piece. The most important advantages are based on the analysis is the help in the identification of nerves in cases of surgeries, as well as the control of nerve function at the conclusion of surgery. As a main disadvantage we have the high cost of the equipment used. The evidence of the age range of the patients studied is from 23 to 76 years. The most frequent pathology treated with this method in our study is papillary cancer in 50% (3), multinodular goiter 16.6% (1), thyroiditis 16.6% (1), follicular adenoma 16.6% (1). The prevalent sex was the feminine one. 100% of the cases. Total thyroidectomy was performed in 5 cases over 6. And in one case lobectomy plus istmectomy.

Palabras clave : Thyroidectomy; neuromonitoring; recurrent laryngeal nerve.

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