Identificação do ramo externo do nervo laríngeo superior na tireoidectomia minimamente invasivo vídeo-assistida

Dedivitis, Rogério Aparecido; Guimarães, André Vicente

doi:10.1590/s0034-72992005000300010

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…This technique has been recommended and is a well-accepted method for soft tissue incisions when the aim is to control bleeding and minimize thermal injury (complementing or replacing electrocautery, laser or even the cold scalpel), and it allows simultaneous cutting and coagulation. Because this method does not use an electrical current, the harmonic scalpel eliminates the risk of burns and it is easy to install and handle, leading to decreased surgical time (1)(2)(3)(4)(5) . The vessel sealing device seals vessels by fusing the inner layers of the vessel wall with minimal levels of thermal dispersion, burning and tissue friction, thereby reducing the incidence of accidental burns (6) .…”

Section: Resumo Objetivosmentioning

confidence: 99%

Impacto do uso da pinça seladora ou do bisturi harmônico nos desfechos intra-hospitalares e no custo de procedimentos de tireoidectomia

Silva

Limoeiro

Bianco

et al. 2012

Einstein (São Paulo)

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Conflicts of interest: none.aBstRact objectives: To analyze the operative time, length of hospitalization and cost, as well as the bleeding and pain observed during the postoperative period, of thyroidectomy procedures using vessel sealing, harmonic scalpel or the conventional technique. methods: Retrospective analysis of thyroidectomies performed between 2007 and 2010 using either the conventional technique or minimally invasive techniques involving vessel sealing or a harmonic scalpel. Gender, age, primary diagnosis and procedure type were analyzed. The outcomes analyzed included the length of the procedure, length of hospital stay, need for blood product transfusions, pain and cost of hospitalization. The findings were based on a significance level of 5%, and statistical analyses were performed using the R software. Results: The use of the vessel sealing increased the duration of the surgery by approximately 47 minutes compared to the conventional technique (p<0.001), and the use of the harmonic scalpel decreased the duration of the surgery by approximately 32 minutes compared to the conventional technique (p<0.001). No statistically significant difference was found between the groups regarding the use of blood products and pain score. Procedures involving vessel sealing or a harmonic scalpel cost more than those using the conventional technique. conclusion: The use of harmonic scalpel was favorable in terms of reducing the surgical time, but there was no reduction in hospitalization time. The cost of the procedure was higher than that of the conventional technique. The use of vessel sealing offered no advantages in terms of the outcomes assessed, and the cost of the procedure was greater than that of the conventional technique.Keywords: Thyroidectomy; Health economics; Cost-effectiveness evaluation; Technology, high-cost ResUmo objetivos: Analisar tempo cirúrgico, tempo de internação, sangramento, escore de dor no período pós-operatório e custo referente aos procedimentos de tireoidectomia com utilização de pinça seladora ou bisturi harmônico, comparando-os à técnica convencional. métodos: Análise retrospectiva das tireoidectomias, realizadas entre 2007 e 2010, pela técnica convencional e com uso de pinça seladora ou bisturi harmônico. Foram analisados: gênero, idade, diagnóstico principal e tipo de procedimento. Os desfechos analisados foram: duração do procedimento, tempo de permanência hospitalar, necessidade de transfusão de hemoderivados, dor e custo da internação. As conclusões foram baseadas em um nível de significância de 5%, e as análises estatísticas foram realizadas utilizando o software R. Resultados: Para o desfecho "duração da cirurgia", o uso da pinça seladora resultou em aumento médio de, aproximadamente, 47 minutos, quando comparado à técnica convencional (p<0,001) e o uso do bisturi harmônico levou à redução média de, aproximadamente, 32 minutos, quando comparado à técnica convencional (p<0,001). Não houve diferença estatisticamente significativa entre os grupos quanto ao uso de hemoderivad...

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Section: Resumo Objetivosmentioning

confidence: 99%

Impacto do uso da pinça seladora ou do bisturi harmônico nos desfechos intra-hospitalares e no custo de procedimentos de tireoidectomia

Silva

Limoeiro

Bianco

et al. 2012

Einstein (São Paulo)

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Surgical anatomy of the external branch of the superior laryngeal nerve and its clinical significance in head and neck surgery

et al. 2008

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Injury of the external branch of the superior laryngeal nerve (EBSLN) increases the morbidity following a variety of neck procedures and can have catastrophic consequences in people who use their voice professionally. Identification and preservation of the EBSLN are thus important in thyroidectomy, parathyroidectomy, carotid endarterectomy, and anterior cervical spine procedures, where the nerve is at risk. There are large variations in the anatomical course of the EBSLN, which makes the intraoperative identification of the nerve challenging. The topographic relationship of the EBSLN to the superior thyroid artery and the upper pole of the thyroid gland are considered by many authors to be the key point for identifying the nerve during surgery of the neck. The classifications by Cernea et al. ([1992a] Head Neck 14:380-383; [1992b] Am. J. Surg. 164:634-639) and by Kierner et al. ([1998] Arch. Otolaryngol. Head Neck Surg. 124:301-303), as well as clinically important connections are discussed in detail. Along with sound anatomical knowledge, neuromonitoring is helpful in identifying the EBSLN during neck procedures. The clinical signs of EBSLN injury include hoarseness, decreased voice projection, decreased pitch range, and fatigue after extensive voice use. Videostroboscopy, electromyography, voice analysis, and electroglottography can provide crucial information on the function of the EBSLN following neck surgery.

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Surgical anatomy of the external branch of the superior laryngeal nerve: a systematic review and meta-analysis

Cheruiyot

Kipkorir

Henry

et al. 2018

Langenbecks Arch Surg

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Identificação do ramo externo do nervo laríngeo superior na tireoidectomia minimamente invasivo vídeo-assistida

Cited by 3 publications

References 9 publications

Impacto do uso da pinça seladora ou do bisturi harmônico nos desfechos intra-hospitalares e no custo de procedimentos de tireoidectomia

Impacto do uso da pinça seladora ou do bisturi harmônico nos desfechos intra-hospitalares e no custo de procedimentos de tireoidectomia

Surgical anatomy of the external branch of the superior laryngeal nerve and its clinical significance in head and neck surgery

Surgical anatomy of the external branch of the superior laryngeal nerve: a systematic review and meta-analysis

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