초록접수 현황
| 19F-217 | 구연 미채택시 포럼 발표 |
Vocal Cord Palsy in Esophagectomy Patients due to Esophageal Cancer : Aspect and Treatment Course of Common Complication
Yong Ho Jeong, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Hyeong Ryul Kim, Se-hoon Choi, Geun Dong Lee, Jae Kwang Yun, Yooyoung Chong
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : This study is set to analyze the recovery of vocal fold paralysis(VCP) in patients after esophageal cancer surgery and provide a plan for treatment.
Methods : During the period between January 2013 and December 2017, 396 esophageal cancer operations were performed. The charts and videolaryngostroboscopy (VLS) examinations of 103 patients complaining of hoarseness or coughing while eating were retrospectively reviewed.
Results : There were 17(16.5 %) patients with no signs of VCP. Left, right, both sided VCP occurred in 45(43.7%), 31(30.1%), 10(9.7%) patients accordingly. HA injection was performed at 56(54.4%) patients with unilateral VCP, and tracheostomy was performed at 3(2.9%) patients with bilateral VCP. Remaining 44(42.7%) patients received no procedures. HA injection relieved symptoms in 89.3%(50/56) of the treated group. Natural recovery occurred in 93.1%(41/44) of patients of the non-treated group and 33.3% recovered after tracheostomy (1/3). Recovery period without treatment showed a mean of 7.76±8.02 months (0.63~35.1 months). HA injected group recovered at a mean period of 11.81±11.81 months (0.9~56.2 months range). There was one case of recurrent laryngeal nerve transection and 5 injuries. Nerve transected patient did not recover from paralysis, but all nerve injured patients recovered from paralysis. Total of 16 gastrostomy was performed due to VCP and 11 recovered from paralysis.
Conclusion : For unilateral vocal cord palsy, quicker HA injection within 1month observation could be advised to reduce hoarseness and improve the quality of oral diet.
For bilateral vocal cord palsy, HA injection is contraindicated. Tracheostomy should be performed if dyspnea continues after observation.
Methods : During the period between January 2013 and December 2017, 396 esophageal cancer operations were performed. The charts and videolaryngostroboscopy (VLS) examinations of 103 patients complaining of hoarseness or coughing while eating were retrospectively reviewed.
Results : There were 17(16.5 %) patients with no signs of VCP. Left, right, both sided VCP occurred in 45(43.7%), 31(30.1%), 10(9.7%) patients accordingly. HA injection was performed at 56(54.4%) patients with unilateral VCP, and tracheostomy was performed at 3(2.9%) patients with bilateral VCP. Remaining 44(42.7%) patients received no procedures. HA injection relieved symptoms in 89.3%(50/56) of the treated group. Natural recovery occurred in 93.1%(41/44) of patients of the non-treated group and 33.3% recovered after tracheostomy (1/3). Recovery period without treatment showed a mean of 7.76±8.02 months (0.63~35.1 months). HA injected group recovered at a mean period of 11.81±11.81 months (0.9~56.2 months range). There was one case of recurrent laryngeal nerve transection and 5 injuries. Nerve transected patient did not recover from paralysis, but all nerve injured patients recovered from paralysis. Total of 16 gastrostomy was performed due to VCP and 11 recovered from paralysis.
Conclusion : For unilateral vocal cord palsy, quicker HA injection within 1month observation could be advised to reduce hoarseness and improve the quality of oral diet.
For bilateral vocal cord palsy, HA injection is contraindicated. Tracheostomy should be performed if dyspnea continues after observation.
책임저자: Yong-Hee Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Yong Ho Jeong, E-mail : fauntleroy@naver.com