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The journal «ONCOSURGERY» 2013, Vol.5, No 2

Surgical prevention for injury of recurrent laryngeal nerve and parathyroid glands

Romanchishen AF, Romanchishen FA, Vabalayte KV

Saint-Petersburg State Pediatric Medical University,
Saint-Petersburg Centre of Endocrine Surgery and Oncology,
Saint-Petersburg, Russia
Contact: Romanchishen Anatoliy Filippovich, e-mail:

The analysis of surgical anatomy specifics of 1268 recurrent laryngeal nerves in 1126 patients operated in City Hospital #122 (one of sites in Saint-Petersburg Centre of Endocrine Surgery and Oncology) for different thyroid and parathyroid diseases in the period from 01-01-2005 to 07-15-2011 with surgeries performed by single surgeon is represented. In 1008 cases thyroid disease was primary, in 118 – recurrent. In 513 (95.0%) of 540 patients with thyroid cancer surgical treatment was complemented with central lymph node dissection. Improvement of search and dissection of recurrent laryngeal nerve was performed on 11 unpreserved and 20 fixated anatomic specimens. Clinical and anatomical research of parathyroid glands was performed on 40 specimens and during 389 surgeries. Tracheoesofageal groove in subclaviar region was shown to be the optimal landmark for search and dissection of recurrent laryngeal nerve. The upward dissection of recurrent laryngeal nerve prevents arterial bleeding, anemization of parathyroid glands, injury of non-recurrent laryngeal nerve. In most cases recurrent laryngeal nerve as one or several branches was crossed by vessels before entry the larynx, transaction and ligation of this vessels provided safe hemostasis. In postoperative period patients with different thyroid and parathyroid diseases need temporary administration of minerals for 1 months to prevent clinical and subclinical hypoparathyroidism.

KEY WORDS: thyroid and parathyroid glands, surgical treatment, complication, prevention.

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