ABSTRACT
En procedimientos quirúrgicos de las regiones supraclaviculares y laterales cervicales, así como en cirugías cardíacas y mediastínicas, la función diafragmática puede comprometerse desde la base del riesgo de lesión del nervio frénico y/o la raíz C4. Son escasas las publicaciones que tratan la estimulación intraoperatoria de estas estructuras nerviosas para evaluar su funcionalidad y, en nuestro conocimiento, hasta ahora no se ha hipotetizado acerca de si es posible reducir las tasas de lesión situadas en hasta el 26% en algunos estudios de cirugía cardíaca. Describimos la técnica empleada para la monitorización neurofisiológica del nervio frénico. Asimismo, se discute su utilidad y ventajas respecto a otras técnicas. Concluimos que con la incorporación creciente de la monitorización neurofisiológica intraoperatoria en los últimos años, es posible su aplicación al nervio frénico en los procedimientos en los que se considere que existe riesgo de lesión del mismo y, con ella, puede ser factible la reducción de las tasas de lesión iatrógena
In surgical procedures of the supraclavicular and lateral cervical regions, as well as in cardiac and mediastinal surgeries, diaphragm function can be compromised by the risk of injury to the phrenic nerve and/or the C4 root. There are few publications that treat the intraoperative stimulation of these nerve structures to evaluate their functionality and, to our knowledge, until now it has not been hypothesized about whether it is possible to reduce the injury rates, which reach 26% in some cardiac surgery studies. We describe the technique used for the neurophysiological monitoring of the phrenic nerve. Also, its usefulness and advantages over other techniques are discussed. We conclude that, with the increasing incorporation in recent years of intraoperative neurophysiological monitoring, its application to the phrenic nerve is possible in procedures with a risk of injury and, thus, the reduction of iatrogenic injury rates may be feasible
Subject(s)
Humans , Intraoperative Neurophysiological Monitoring/methods , Phrenic Nerve/surgery , Xiphoid Bone/surgery , Cardiac Surgical Procedures , Surgical Procedures, OperativeABSTRACT
In surgical procedures of the supraclavicular and lateral cervical regions, as well as in cardiac and mediastinal surgeries, diaphragm function can be compromised by the risk of injury to the phrenic nerve and/or the C4 root. There are few publications that treat the intraoperative stimulation of these nerve structures to evaluate their functionality and, to our knowledge, until now it has not been hypothesized about whether it is possible to reduce the injury rates, which reach 26% in some cardiac surgery studies. We describe the technique used for the neurophysiological monitoring of the phrenic nerve. Also, its usefulness and advantages over other techniques are discussed. We conclude that, with the increasing incorporation in recent years of intraoperative neurophysiological monitoring, its application to the phrenic nerve is possible in procedures with a risk of injury and, thus, the reduction of iatrogenic injury rates may be feasible.
Subject(s)
Intraoperative Neurophysiological Monitoring/methods , Phrenic Nerve/physiology , HumansABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Neurilemmoma/surgery , Neurilemmoma , Parathyroid Neoplasms/surgery , Parathyroid Neoplasms , Vagus Nerve/pathology , Vagus Nerve/surgery , Vagus Nerve , Adenoma/pathology , Adenoma/surgery , AdenomaABSTRACT
No disponible
Subject(s)
Humans , Female , Adult , Recurrent Laryngeal Nerve/pathology , Recurrent Laryngeal Nerve/surgery , Thyroid Neoplasms/complications , Thyroid Neoplasms/surgery , Thyroid Neoplasms , Thyroidectomy/methods , Thyroidectomy , Lymph Node Excision/methods , Deglutition Disorders/complications , Hypocalcemia/complicationsSubject(s)
Adenoma/diagnosis , Cranial Nerve Neoplasms/diagnosis , Diagnostic Errors , Head and Neck Neoplasms/diagnosis , Neurilemmoma/diagnosis , Parathyroid Neoplasms/diagnosis , Vagus Nerve Diseases/diagnosis , Vagus Nerve/pathology , Adenoma/diagnostic imaging , Cranial Nerve Neoplasms/diagnostic imaging , Cranial Nerve Neoplasms/surgery , Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/surgery , Humans , Hyperparathyroidism, Primary/surgery , Intraoperative Period , Male , Middle Aged , Neurilemmoma/diagnostic imaging , Neurilemmoma/surgery , Parathyroid Neoplasms/diagnostic imaging , Parathyroidectomy , Reoperation , Tomography, X-Ray Computed , Ultrasonography , Vagus Nerve/diagnostic imaging , Vagus Nerve/surgery , Vagus Nerve Diseases/diagnostic imaging , Vagus Nerve Diseases/surgerySubject(s)
Carcinoma, Papillary/surgery , Recurrent Laryngeal Nerve/abnormalities , Thyroid Neoplasms/surgery , Adult , Carcinoma, Papillary/complications , Female , Goiter, Nodular/complications , Goiter, Nodular/surgery , Humans , Incidental Findings , Intraoperative Complications/prevention & control , Laryngeal Nerve Injuries/prevention & control , Thyroid Neoplasms/complications , Vocal Cord Paralysis/prevention & controlABSTRACT
Retained gastric antrum arises when there is incomplete excision of the gastric antrum during Billroth II gastrectomy for peptic ulcer disease. We report the case of a patient with gallstones in a retained gastric antrum, without biliodigestive fistula. This finding is extremely rare and we have found no previously reported cases in the literature.
Subject(s)
Cholelithiasis/diagnostic imaging , Cholelithiasis/surgery , Pyloric Antrum/diagnostic imaging , Pyloric Antrum/surgery , Biliary Fistula/diagnostic imaging , Gastrectomy , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
El antro gástrico retenido tiene lugar cuando se realiza una exéresis incompleta del antro gástrico durante una gastrectomía tipo Billroth II por enfermedad ulcerosa péptica. Se presenta el caso de un paciente con antro gástrico retenido con una concreción litiásica en su interior, sin fístula biliodigestiva, como un hallazgo extraordinariamente raro que no hemos encontrado descrito previamente en la literatura (AU)
Retained gastric antrum arises when there is incomplete excision of the gastric antrum during Billroth II gastrectomy for peptic ulcer disease. We report the case of a patient with gallstones in a retained gastric antrum, without biliodigestive fistula. This finding is extremely rare and we have found no previously reported cases in the literature (AU)
