Medico-Legal Issues of Intraoperative Neuromonitoring in Thyroid Surgery

• 발행기관: 대한내분비외과학회
• 저자명: Hoon Yub Kim Xiaoli Liu Hui Sun Che-Wei Wu Young Jun Chai Woong Youn Chung Ralph Tufano Henning Dralle Matteo Lavazza Gianlorenzo Dionigi
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』17권2호, 42~56쪽, 전체 15쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2017.06.30

영문 초록

Advances in intraoperative neuromonitoring (IONM) in thyroid surgery have provided significant insights into recurrent laryngeal nerve function during thyroid surgery. Despite the limitations and necessary caution when using intraoperative monitors to interpret neural function, these technologies have been definite steps in the right direction for assessing neural integrity and safe surgical strategy during thyroid operations. The techniques discussed minimize the adverse sequelae of a variety of thyroid gland procedures, reducing the morbidity rates/risks in the perioperative period. Furthermore, it is likely that such monitoring will become a standard of care. Accurate, reliable and continuous monitoring is essential, and on-going large studies with definable end points will be necessary. The use of monitoring, such as continuous one, may improve cost efficiency by reducing permanent nerve injuries. A danger in this process, however, is the potential for public opinion, outside regulatory bodies, or medico-legal implications to drive change and enforce standards of care before appropriate data are available.

목차

INTRODUCTION

RISK FACTORS FOR INJURIES OF THE RLN

INTERPRETATION OF NEUROMONITORING EMG SIGNALS

IONM DOCUMENTATION

PROCEDURE FOR EMG SIGNAL FAILURE AND VCP

AVOID BILATERAL VCP

IONM IN DIFFICULT THYROID PROCEDURES

IONM IN MALPRACTICE CLAIMS

STANDARD OF CARE IN THYROID SURGERY

COST OF IONM

CONCLUSION

REFERENCES

키워드

Thyroid gland Recurrent laryngeal nerve Malpractice Recurrent laryngeal nerve injuries Thyroidectomy