The recurrent laryngeal nerve (RLN): application to transhiatal oesophagectomy

Respiratory Complications After Esophagectomy

Pulmonary complications are the major source of morbidity and mortality after esophageal resection, and numerous studies have identified various associated with these complications. This article discusses preoperative, intraoperative, and postoperative factors affecting pulmonary complications and strategies to reduce these complications after esophagectomy.

Prevalence of long-term upper aerodigestive symptoms after uncomplicated bilateral thyroidectomy

BACKGROUND

Subjective nonspecific upper aerodigestive symptoms (UADS) are not uncommon after thyroidectomy. Their type, duration, and prevalence, however, have not been investigated in a controlled design. The objective of this study was to investigate the prevalence of UADS after thyroidectomy.

METHODS

A consecutive cohort of 60 patients who had undergone uncomplicated total (n = 38) or near total (n = 22) thyroidectomy were investigated retrospectively at a mean of 4 years after surgery. An independent unblinded researcher interviewed each patient and asked for the presence or frequency of voice changes, cough, dysphagia, neck strangling, and annual incidence of common colds, before and after thyroidectomy. Sixty patients, matched for age, sex, and smoking habits, who had undergone laparoscopic cholecystectomy during the same years served as control subjects.

RESULTS

The prevalence of UADS was similar before thyroidectomy (13%) and cholecystectomy (15%). After operation, UADS had a higher prevalence among thyroidectomized patients: nonspecific voice changes (28% vs 3%), neck strangling (22% vs 0%), and impaired swallowing (15% vs 3%) (P < or = .02 in each). Neck strangling was associated with voice changes and dysphagia (P < or = .03 each).

CONCLUSIONS

Subjective UADS are common long after thyroidectomy. These symptoms may be related to injury to the extrinsic perithyroidal neural plexus innervating the pharyngeal and laryngeal structures.