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Recurrent Nerve Injury After Total Thyroidectomy: Risk Factor Analysis of a Targeted NSQIP Data Set.

David A Mahvi1, Lily V Saadat1, Jamie Knell1

  • 1Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.

The American Surgeon
|November 23, 2021
PubMed
Summary
This summary is machine-generated.

Recurrent laryngeal nerve (RLN) injury after thyroidectomy is common, affecting 7.1% of patients. Risk factors include race and non-elective surgery, with intraoperative neuromonitoring potentially reducing complication severity.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Neurosurgery

Background:

  • Recurrent laryngeal nerve (RLN) injury is a significant complication following thyroidectomy.
  • Identifying risk factors and associated postoperative complications is crucial for quality improvement.

Purpose of the Study:

  • To identify risk factors associated with RLN injury during thyroidectomy.
  • To analyze the impact of RLN injury on postoperative complications.

Main Methods:

  • Utilized the ACS-NSQIP thyroidectomy-targeted database (2016-2017).
  • Included patients undergoing total thyroidectomy.
  • Employed univariable and multivariable regression analyses to identify predictors of RLN injury.

Main Results:

  • Overall RLN injury rate was 7.1% (467/6538).
  • Factors associated with injury included African American and Asian race, non-elective surgery, parathyroid auto-transplantation, and lack of intraoperative neuromonitoring (IONM).
  • RLN injury correlated with increased cardiopulmonary complications, re-intubation, longer hospital stay, readmission, and reoperation.

Conclusions:

  • RLN injury is a frequent complication of thyroidectomy, leading to substantial morbidity.
  • Preoperative patient characteristics can aid in risk stratification.
  • Intraoperative neuromonitoring may reduce the severity of postoperative complications, though it does not eliminate all risks.