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首页> 外文期刊>The Journal of Thoracic and Cardiovascular Surgery >Concomitant type I thyroplasty and thoracic operations for lung cancer: preventing respiratory complications associated with vagus or recurrent laryngeal nerve injury.
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Concomitant type I thyroplasty and thoracic operations for lung cancer: preventing respiratory complications associated with vagus or recurrent laryngeal nerve injury.

机译：肺癌同时进行I型胸廓成形术和胸外科手术：预防与迷走神经或喉返神经损伤相关的呼吸系统并发症。

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OBJECTIVES: We sought to prevent postoperative swallowing disorder, aspiration, and sputum retention in cases of recurrent laryngeal or vagus nerve section occurring during lung cancer resection. METHODS: In 14 of 25 consecutive patients, type I thyroplasty and thoracic operations were performed during the same period of anesthesia. All patients had a preoperative laryngeal computed tomographic scan providing us with indispensable measurements for vocal fold medialization under general anesthesia (ie, without intraoperative phonatory control). Nine remaining patients had a type I thyroplasty delayed from thoracic operations because of intraoperative doubt about laryngeal innervation injury, and 2 did not need a laryngeal operation. Main postoperative records consisted of swallowing ability, respiratory complications, and quality of voice. RESULTS: No swallowing disorder, aspiration, or sputum retention occurred in cases of concomitant laryngeal and thoracic operations. Of these 14 patients, a single case (7%) of major complication (vocal fold overmedialization) occurred and required an early and successful revision thyroplasty; one case of cervical hematoma that did not require surgical drainage was considered a minor complication (7%). Twelve (86%) patients who underwent the concomitant association of both operations were fully satisfied with their quality of voice. CONCLUSIONS: Type I thyroplasty and thoracic operation can be advantageously associated in case of injury to laryngeal motor innervation to prevent postoperative swallowing disability and dramatic respiratory complications.
机译：目的：在肺癌切除过程中发生喉返神经或迷走神经切片复发的情况下，我们试图防止术后吞咽障碍，误吸和痰液retention留。方法：在25例连续的患者中，有14例在同一麻醉期间进行了I型甲状腺成形术和胸腔手术。所有患者术前均进行了喉计算机断层扫描，为我们提供了在全身麻醉（即，术中未进行声控）的情况下声带介质化的必不可少的测量方法。剩下的9名患者由于术中对喉管神经支配损伤的怀疑而进行了I型甲状腺成形术，但由于2例不需要进行喉管手术而被推迟了开胸手术。术后主要记录包括吞咽能力，呼吸系统并发症和声音质量。结果：伴有喉和胸腔手术的患者未发生吞咽障碍，误吸或痰液retention留。在这14例患者中，有1例（7％）严重并发症（声带过度介导）发生，需要早期成功进行翻修术。一例不需要手术引流的宫颈血肿被认为是轻度并发症（7％）。十二种（86％）同时进行了两种手术的患者对其声音质量完全满意。结论：I型甲状腺成形术和胸腔手术可以在喉部运动神经受损伤的情况下有利地结合在一起，以防止术后吞咽障碍和剧烈的呼吸系统并发症。

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