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Short- and Long-term Progress of Recurrent Laryngeal Nerve Paralysis After Subtotal Esophagectomy
Hiroki Shimizu1, Atsushi Shiozaki2, Hitoshi Fujiwara1
1Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Aim:
To clarify risk factors and long-term progress of postoperative recurrent laryngeal nerve paralysis (PRNP) in patients with esophageal cancer.
Patients And Methods:
One hundred and twenty-five esophageal cancer patients, who underwent subtotal esophagetomy, including recurrent laryngeal nerve lymphadenectomy, were analyzed. A laryngoscopy was routinely performed to assess the motility of vocal cords.
Results:
PRNP was detected in 79 patients and 26 (20.8%) patients required medical interventions (Grade II or more by the Clavien-Dindo classification; group II). Forty-one of 66 (62.1%) patients recovered from PRNP with a median postoperative time of 135 days. The three-field lymphadenectomy and long operative time were the independent prognostic factors of group II.
Conclusion:
Radical operation caused PRNP with grade II or more. The long-term follow-up of vocal cords was necessary to detect patients with either transient or permanent PRNP.