Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery
Abstract Background Systematic nodal dissection plays a crucial role in improving survival and staging in resectable non-small cell lung cancer (NSCLC) patients but at the cost of increasing the occurrence of recurrent laryngeal nerve injury. Technology should be improved to protect the recurrent la...
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doaj-ad42ff44e5ea4b7ba722be410b4fc24f2021-04-04T11:22:31ZengBMCBMC Surgery1471-24822021-03-012111710.1186/s12893-021-01179-2Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgeryMinhao Yu0Mingjian Ge1Department of Thoracic Surgery, Chengdu BOE HospitalDepartment of Thoracic Surgery, The First Affiliated Hospital of Chongqing Medical UniversityAbstract Background Systematic nodal dissection plays a crucial role in improving survival and staging in resectable non-small cell lung cancer (NSCLC) patients but at the cost of increasing the occurrence of recurrent laryngeal nerve injury. Technology should be improved to protect the recurrent laryngeal nerve (RLN) during surgery. Methods NSCLC patients who underwent video-assisted thoracic surgery (VATS) surgical treatment by the same surgeon at our hospital from January 2016 to December 2017 were included as the research subjects and were divided into an energy-device group and a non-energy-device group. Their procedures included anatomic pulmonary resection, normative N1 dissection, and systemic N2 dissection. Results The rate of metastatically involved recurrent laryngeal nerve lymph nodes (RLNLNs) was 5.19% (39/752). Dissection device, side of primary, FEV1, operative time and BMI were independent predictors of recurrent laryngeal nerve injury (RLNI) (hazard ratio (HR) = 3.576, 95% confidence interval (CI): 1.490–8.583, P = 0.004; HR = 0.175, 95% CI: 0.072–0.424, P = < 0.001; HR = 3.008, 95% CI: 1.30–6.927, P = 0.010; HR = 0.328, 95% CI: 0.136–0.794, P = 0.013; HR = 0.344, 95%CI: 0.147–0.801, P = 0.013, respectively). Patients in the non-energy-device group had significantly less RLNI than the energy-device group (P = 0.016) and nearly half of the non-thermal RLNI recovered in 2 weeks (P = 0.025) whereas most thermal RLNI required 3 months for recovery. Conclusions Every station of RLNLN had some degree of cancer metastasis in NSCLC patients and when dissecting RLNLNs, dissection device was an independent and artificially controlled predictor of RLNI. Using a non-energy device is a feasible method to protect the RLN as well as an improved recovery time of RLNI.https://doi.org/10.1186/s12893-021-01179-2Non-small cell lung cancerRecurrent laryngeal nerve injuryNon-energy deviceSystematic nodal dissection |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Minhao Yu Mingjian Ge |
spellingShingle |
Minhao Yu Mingjian Ge Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery BMC Surgery Non-small cell lung cancer Recurrent laryngeal nerve injury Non-energy device Systematic nodal dissection |
author_facet |
Minhao Yu Mingjian Ge |
author_sort |
Minhao Yu |
title |
Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery |
title_short |
Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery |
title_full |
Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery |
title_fullStr |
Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery |
title_full_unstemmed |
Non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery |
title_sort |
non-energy devices to dissect recurrent laryngeal nerve lymph nodes of non-small cell lung cancer under video-assisted thoracic surgery |
publisher |
BMC |
series |
BMC Surgery |
issn |
1471-2482 |
publishDate |
2021-03-01 |
description |
Abstract Background Systematic nodal dissection plays a crucial role in improving survival and staging in resectable non-small cell lung cancer (NSCLC) patients but at the cost of increasing the occurrence of recurrent laryngeal nerve injury. Technology should be improved to protect the recurrent laryngeal nerve (RLN) during surgery. Methods NSCLC patients who underwent video-assisted thoracic surgery (VATS) surgical treatment by the same surgeon at our hospital from January 2016 to December 2017 were included as the research subjects and were divided into an energy-device group and a non-energy-device group. Their procedures included anatomic pulmonary resection, normative N1 dissection, and systemic N2 dissection. Results The rate of metastatically involved recurrent laryngeal nerve lymph nodes (RLNLNs) was 5.19% (39/752). Dissection device, side of primary, FEV1, operative time and BMI were independent predictors of recurrent laryngeal nerve injury (RLNI) (hazard ratio (HR) = 3.576, 95% confidence interval (CI): 1.490–8.583, P = 0.004; HR = 0.175, 95% CI: 0.072–0.424, P = < 0.001; HR = 3.008, 95% CI: 1.30–6.927, P = 0.010; HR = 0.328, 95% CI: 0.136–0.794, P = 0.013; HR = 0.344, 95%CI: 0.147–0.801, P = 0.013, respectively). Patients in the non-energy-device group had significantly less RLNI than the energy-device group (P = 0.016) and nearly half of the non-thermal RLNI recovered in 2 weeks (P = 0.025) whereas most thermal RLNI required 3 months for recovery. Conclusions Every station of RLNLN had some degree of cancer metastasis in NSCLC patients and when dissecting RLNLNs, dissection device was an independent and artificially controlled predictor of RLNI. Using a non-energy device is a feasible method to protect the RLN as well as an improved recovery time of RLNI. |
topic |
Non-small cell lung cancer Recurrent laryngeal nerve injury Non-energy device Systematic nodal dissection |
url |
https://doi.org/10.1186/s12893-021-01179-2 |
work_keys_str_mv |
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