초록접수 현황
| 19F-261 | 구연 발표 |
Application of Continuous Vagal Intraoperative Neuromonitoring during Video-assisted Thoracoscopic Surgery Lobectomy for Left Lung Cancer to Prevent Recurrent Laryngeal Nerve Injury
Young Jun Chai¹, Jung-Man Lee², Yong Won Seong³, Hyeon Jong Moon³
¹Department of Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea, ²Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea, ³Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Video-assisted thoracoscopic surgery (VATS) lobectomy is a standard procedure for the treatment of early-stage lung cancer. Recurrent laryngeal nerve (RLN) injury is a common complication of this procedure. We applied continuous intraoperative neuromonitoring (CIONM) during VATS lobectomy for left lung cancer and evaluated its safety and usefulness.
Methods : Patients diagnosed with early-stage left lung cancer who were indicated for VATS lobectomy were enrolled. Electrode was attached to double-lumen tube, and placed at vocal cord level to detect EMG signal evoked by vocal cord movement. Before 4L lymph node dissection, an automatic periodic stimulation device was applied to the vagus nerve to stimulate vagus nerve continuously. Surgery was suspended if the amplitude decreased lower than the threshold and was resumed when the amplitude recovered.
Results : Ten patients (6 male, 4 female) were enrolled. CIONM was successfully performed in all patients without technical failure, and there was no hemodynamic instability. Amplitude decreased below the threshold in four patients. One patient did not recover amplitude and experienced transient vocal cord palsy. In the three other patients, the amplitude recovered above the threshold and no vocal cord palsy occurred. The six patients who did not exhibit amplitude decrease experienced no vocal cord palsy.
Conclusion : Our results suggest that CIONM may be applied safely for VATS left lobectomy and may be used to predict postoperative vocal cord function. This approach may be helpful to prevent RLN injury during VATS left lobectomy.
Methods : Patients diagnosed with early-stage left lung cancer who were indicated for VATS lobectomy were enrolled. Electrode was attached to double-lumen tube, and placed at vocal cord level to detect EMG signal evoked by vocal cord movement. Before 4L lymph node dissection, an automatic periodic stimulation device was applied to the vagus nerve to stimulate vagus nerve continuously. Surgery was suspended if the amplitude decreased lower than the threshold and was resumed when the amplitude recovered.
Results : Ten patients (6 male, 4 female) were enrolled. CIONM was successfully performed in all patients without technical failure, and there was no hemodynamic instability. Amplitude decreased below the threshold in four patients. One patient did not recover amplitude and experienced transient vocal cord palsy. In the three other patients, the amplitude recovered above the threshold and no vocal cord palsy occurred. The six patients who did not exhibit amplitude decrease experienced no vocal cord palsy.
Conclusion : Our results suggest that CIONM may be applied safely for VATS left lobectomy and may be used to predict postoperative vocal cord function. This approach may be helpful to prevent RLN injury during VATS left lobectomy.
책임저자: Hyeon Jong Moon
Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Hyeon Jong Moon, E-mail : moon730@brmh.org