Vocal cord paralysis after subtotal oesophagectomy
Background: Although vocal cord paralysis is a well known complication of subtotal oesophagectomy, precise data concerning origin, incidence and associated morbidity are lacking. Methods: A retrospective study was performed of 241 patients who underwent transhiatal oesophagectomy for carcinoma of th...
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| Veröffentlicht in: | British journal of surgery 1999-12, Vol.86 (12), p.1583-1587 |
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| creator | Hulscher, J. B. F. van Sandick, J. W. Devriese, P. P. van Lanschot, J. J. B. Obertop, H. |
| description | Background:
Although vocal cord paralysis is a well known complication of subtotal oesophagectomy, precise data concerning origin, incidence and associated morbidity are lacking.
Methods:
A retrospective study was performed of 241 patients who underwent transhiatal oesophagectomy for carcinoma of the mid/distal oesophagus between 1994 and 1998. Preoperative and postoperative laryngoscopy results were available for 140 patients.
Results:
There were 109 men and 31 women, of mean age 63 years. Thirty‐one patients (22 per cent) with recurrent laryngeal nerve paralysis were identified, three with bilateral and 28 with unilateral dysfunction. Paralysis occurred ipsilateral to the side of the cervical incision in 22 of 28 patients. It was permanent in six patients. The associated morbidity was substantial: pulmonary complications were more common in patients with vocal cord paralysis (12 of 31 versus 26 (24 per cent) of 109), leading to significantly more reintubations, and a significantly prolonged ventilation time and stay in the intensive care unit.
Conclusion:
Although mostly transient, vocal cord paralysis is a frequent complication with significant associated morbidity. In an extended transthoracic resection (including a lymphadenectomy in the aortopulmonary window where the left recurrent laryngeal nerve is at risk) the cervical anastomosis should be made on the left side, to minimize the risk of bilateral vocal cord paralysis. © 1999 British Journal of Surgery Society Ltd |
| doi_str_mv | 10.1046/j.1365-2168.1999.01333.x |
| format | Article |
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Although vocal cord paralysis is a well known complication of subtotal oesophagectomy, precise data concerning origin, incidence and associated morbidity are lacking.
Methods:
A retrospective study was performed of 241 patients who underwent transhiatal oesophagectomy for carcinoma of the mid/distal oesophagus between 1994 and 1998. Preoperative and postoperative laryngoscopy results were available for 140 patients.
Results:
There were 109 men and 31 women, of mean age 63 years. Thirty‐one patients (22 per cent) with recurrent laryngeal nerve paralysis were identified, three with bilateral and 28 with unilateral dysfunction. Paralysis occurred ipsilateral to the side of the cervical incision in 22 of 28 patients. It was permanent in six patients. The associated morbidity was substantial: pulmonary complications were more common in patients with vocal cord paralysis (12 of 31 versus 26 (24 per cent) of 109), leading to significantly more reintubations, and a significantly prolonged ventilation time and stay in the intensive care unit.
Conclusion:
Although mostly transient, vocal cord paralysis is a frequent complication with significant associated morbidity. In an extended transthoracic resection (including a lymphadenectomy in the aortopulmonary window where the left recurrent laryngeal nerve is at risk) the cervical anastomosis should be made on the left side, to minimize the risk of bilateral vocal cord paralysis. © 1999 British Journal of Surgery Society Ltd</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1046/j.1365-2168.1999.01333.x</identifier><identifier>PMID: 10594510</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Biological and medical sciences ; Esophageal Neoplasms - surgery ; Esophagectomy - adverse effects ; Esophagus ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Prognosis ; Retrospective Studies ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Vocal Cord Paralysis - etiology</subject><ispartof>British journal of surgery, 1999-12, Vol.86 (12), p.1583-1587</ispartof><rights>1999 British Journal of Surgery Society Ltd</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4978-64b6957bfb807d8f1be3e7f313f909bb76172813820037d71d508510cec719c53</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1365-2168.1999.01333.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1365-2168.1999.01333.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1199120$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10594510$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hulscher, J. B. F.</creatorcontrib><creatorcontrib>van Sandick, J. W.</creatorcontrib><creatorcontrib>Devriese, P. P.</creatorcontrib><creatorcontrib>van Lanschot, J. J. B.</creatorcontrib><creatorcontrib>Obertop, H.</creatorcontrib><title>Vocal cord paralysis after subtotal oesophagectomy</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Although vocal cord paralysis is a well known complication of subtotal oesophagectomy, precise data concerning origin, incidence and associated morbidity are lacking.
Methods:
A retrospective study was performed of 241 patients who underwent transhiatal oesophagectomy for carcinoma of the mid/distal oesophagus between 1994 and 1998. Preoperative and postoperative laryngoscopy results were available for 140 patients.
Results:
There were 109 men and 31 women, of mean age 63 years. Thirty‐one patients (22 per cent) with recurrent laryngeal nerve paralysis were identified, three with bilateral and 28 with unilateral dysfunction. Paralysis occurred ipsilateral to the side of the cervical incision in 22 of 28 patients. It was permanent in six patients. The associated morbidity was substantial: pulmonary complications were more common in patients with vocal cord paralysis (12 of 31 versus 26 (24 per cent) of 109), leading to significantly more reintubations, and a significantly prolonged ventilation time and stay in the intensive care unit.
Conclusion:
Although mostly transient, vocal cord paralysis is a frequent complication with significant associated morbidity. In an extended transthoracic resection (including a lymphadenectomy in the aortopulmonary window where the left recurrent laryngeal nerve is at risk) the cervical anastomosis should be made on the left side, to minimize the risk of bilateral vocal cord paralysis. © 1999 British Journal of Surgery Society Ltd</description><subject>Biological and medical sciences</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - adverse effects</subject><subject>Esophagus</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Vocal Cord Paralysis - etiology</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkF1PgzAUhhujcXP6FwwXxjuwhwJt45Wibpplxvh12ZRSlAljUojj31vcnF6di_O8J-d9EHIAe4CD6GzuAYlC14eIecA59zAQQrzVDhpuF7toiDGmLhCfDNCBMXNsKRz6-2gAOORBCHiI_JdKycJRVZ06S1nLojO5cWTW6NoxbdJUjd1W2lTLd_mmVVOV3SHay2Rh9NFmjtDzzfVTPHGn9-Pb-GLqqoBT5kZBEvGQJlnCME1ZBokmmmYESMYxTxIaAfUZEOZjTGhKIQ0xsz8prShwFZIROl3fXdbVZ6tNI8rcKF0UcqGr1oiIk4DbihY83oBtUupULOu8lHUnflta4GQDSGPbZrVcqNz8cVYh-D12vsa-8kJ3_86IXrqYi96t6N2KXrr4kS5W4vLuEZhNu-t0bhq92qZl_SEiSmgoXmdjcfUwiWPiB2JGvgGd0YF_</recordid><startdate>19991201</startdate><enddate>19991201</enddate><creator>Hulscher, J. B. F.</creator><creator>van Sandick, J. W.</creator><creator>Devriese, P. P.</creator><creator>van Lanschot, J. J. B.</creator><creator>Obertop, H.</creator><general>Blackwell Science Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>19991201</creationdate><title>Vocal cord paralysis after subtotal oesophagectomy</title><author>Hulscher, J. B. F. ; van Sandick, J. W. ; Devriese, P. P. ; van Lanschot, J. J. B. ; Obertop, H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4978-64b6957bfb807d8f1be3e7f313f909bb76172813820037d71d508510cec719c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Biological and medical sciences</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagectomy - adverse effects</topic><topic>Esophagus</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Vocal Cord Paralysis - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hulscher, J. B. F.</creatorcontrib><creatorcontrib>van Sandick, J. W.</creatorcontrib><creatorcontrib>Devriese, P. P.</creatorcontrib><creatorcontrib>van Lanschot, J. J. B.</creatorcontrib><creatorcontrib>Obertop, H.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hulscher, J. B. F.</au><au>van Sandick, J. W.</au><au>Devriese, P. P.</au><au>van Lanschot, J. J. B.</au><au>Obertop, H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Vocal cord paralysis after subtotal oesophagectomy</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>1999-12-01</date><risdate>1999</risdate><volume>86</volume><issue>12</issue><spage>1583</spage><epage>1587</epage><pages>1583-1587</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Although vocal cord paralysis is a well known complication of subtotal oesophagectomy, precise data concerning origin, incidence and associated morbidity are lacking.
Methods:
A retrospective study was performed of 241 patients who underwent transhiatal oesophagectomy for carcinoma of the mid/distal oesophagus between 1994 and 1998. Preoperative and postoperative laryngoscopy results were available for 140 patients.
Results:
There were 109 men and 31 women, of mean age 63 years. Thirty‐one patients (22 per cent) with recurrent laryngeal nerve paralysis were identified, three with bilateral and 28 with unilateral dysfunction. Paralysis occurred ipsilateral to the side of the cervical incision in 22 of 28 patients. It was permanent in six patients. The associated morbidity was substantial: pulmonary complications were more common in patients with vocal cord paralysis (12 of 31 versus 26 (24 per cent) of 109), leading to significantly more reintubations, and a significantly prolonged ventilation time and stay in the intensive care unit.
Conclusion:
Although mostly transient, vocal cord paralysis is a frequent complication with significant associated morbidity. In an extended transthoracic resection (including a lymphadenectomy in the aortopulmonary window where the left recurrent laryngeal nerve is at risk) the cervical anastomosis should be made on the left side, to minimize the risk of bilateral vocal cord paralysis. © 1999 British Journal of Surgery Society Ltd</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>10594510</pmid><doi>10.1046/j.1365-2168.1999.01333.x</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Biological and medical sciences Esophageal Neoplasms - surgery Esophagectomy - adverse effects Esophagus Female Humans Male Medical sciences Middle Aged Prognosis Retrospective Studies Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Vocal Cord Paralysis - etiology |
| title | Vocal cord paralysis after subtotal oesophagectomy |
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