Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the Neck

OBJECTIVE To investigate the clinical value in a comparison between intraoperative exposure and non-exposure of the recurrent laryngeal nerve (RLN) of the neck during left neck esophagogastric anastomosis following resection of carcinomas of the middle and inferior-segment esophagus. METHODS...

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Main Authors: Xiang-yang WEI, Chun-hong YANG
Format: Article
Language:English
Published: China Anti-Cancer Association 2010-06-01
Series:Cancer Biology & Medicine
Subjects:
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author Xiang-yang WEI
Chun-hong YANG
author_facet Xiang-yang WEI
Chun-hong YANG
author_sort Xiang-yang WEI
collection DOAJ
description OBJECTIVE To investigate the clinical value in a comparison between intraoperative exposure and non-exposure of the recurrent laryngeal nerve (RLN) of the neck during left neck esophagogastric anastomosis following resection of carcinomas of the middle and inferior-segment esophagus. METHODS From January 2003 to April 2009, 237 patients were selected to undergo resection of esophageal squamous carcinoma via posteroexternal incision of the let chest plus gastroesophageal anastomosis at the let neck incision. The 237 cases were divided into 2 groups: 115 of the total cases were in group A (the study group), cases of resections with neck RLN exposure. Of the patients in this group, 64 were male and 51 female, with a mean age of 49 ranging from 31 to 73 years. Another 122 cases were in group B (the control group), cases of resections without neck RLN exposure. In this group, 51 of the patients were male and 71 female, with a mean age of 45 ranging from 33 to 75 years. In the 2 groups, there were 9 cases in total with symptoms induced by RLN injury. RESULTS Hoarseness, choking cough when drinking, and difficult expectoration were found in 1 of the cases (1/115) in group A (0.087%), while there were 8 cases (8/122) resenting with these symptoms in group B (6.5%). There is statistical significance in the differences of RLN injury between the 2 groups (P < 0.05). CONCLUSION Analysis of study cases of esophageal carcinoma resection with left-neck esophagogastric anastomosis in the 2 groups indicated that the exposure of the RLN in group A resulted in an obviously lower rate of neck RLN injury after the surgery, compared to group B, where the RLN was not exposed. Exposure can lead to the avoidance of complications induced by RLN injury, such as dysarthria and choking cough when eating. As a result, satisfactory expectoration, which would diminish the incidence of pulmonary complications, can be reached allowing the patients to recover as early as possible. The results of our study suggest that the exposure of the RLN during the let -neck esophagogastric anastomosis has signifi cant clinical value, and that this approach can be recommended with confi dence.
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spelling doaj.art-48b3bd7c793440e4bb8aaa046653fb9d2022-12-21T21:52:46ZengChina Anti-Cancer AssociationCancer Biology & Medicine2095-39412010-06-017320620910.1007/s11805-010-0519-7Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the NeckXiang-yang WEIChun-hong YANGOBJECTIVE To investigate the clinical value in a comparison between intraoperative exposure and non-exposure of the recurrent laryngeal nerve (RLN) of the neck during left neck esophagogastric anastomosis following resection of carcinomas of the middle and inferior-segment esophagus. METHODS From January 2003 to April 2009, 237 patients were selected to undergo resection of esophageal squamous carcinoma via posteroexternal incision of the let chest plus gastroesophageal anastomosis at the let neck incision. The 237 cases were divided into 2 groups: 115 of the total cases were in group A (the study group), cases of resections with neck RLN exposure. Of the patients in this group, 64 were male and 51 female, with a mean age of 49 ranging from 31 to 73 years. Another 122 cases were in group B (the control group), cases of resections without neck RLN exposure. In this group, 51 of the patients were male and 71 female, with a mean age of 45 ranging from 33 to 75 years. In the 2 groups, there were 9 cases in total with symptoms induced by RLN injury. RESULTS Hoarseness, choking cough when drinking, and difficult expectoration were found in 1 of the cases (1/115) in group A (0.087%), while there were 8 cases (8/122) resenting with these symptoms in group B (6.5%). There is statistical significance in the differences of RLN injury between the 2 groups (P < 0.05). CONCLUSION Analysis of study cases of esophageal carcinoma resection with left-neck esophagogastric anastomosis in the 2 groups indicated that the exposure of the RLN in group A resulted in an obviously lower rate of neck RLN injury after the surgery, compared to group B, where the RLN was not exposed. Exposure can lead to the avoidance of complications induced by RLN injury, such as dysarthria and choking cough when eating. As a result, satisfactory expectoration, which would diminish the incidence of pulmonary complications, can be reached allowing the patients to recover as early as possible. The results of our study suggest that the exposure of the RLN during the let -neck esophagogastric anastomosis has signifi cant clinical value, and that this approach can be recommended with confi dence.esophageal neoplasmsurgical anastomosisrecurrent laryngeal nerve.
spellingShingle Xiang-yang WEI
Chun-hong YANG
Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the Neck
Cancer Biology & Medicine
esophageal neoplasm
surgical anastomosis
recurrent laryngeal nerve.
title Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the Neck
title_full Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the Neck
title_fullStr Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the Neck
title_full_unstemmed Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the Neck
title_short Clinical Signifi cance of Recurrent Laryngeal Nerve Exposure During Esophagogastric Anastomosis of the Neck
title_sort clinical signifi cance of recurrent laryngeal nerve exposure during esophagogastric anastomosis of the neck
topic esophageal neoplasm
surgical anastomosis
recurrent laryngeal nerve.
work_keys_str_mv AT xiangyangwei clinicalsignificanceofrecurrentlaryngealnerveexposureduringesophagogastricanastomosisoftheneck
AT chunhongyang clinicalsignificanceofrecurrentlaryngealnerveexposureduringesophagogastricanastomosisoftheneck