食管癌术中喉返神经损伤因素的研究进展

Research progress on factors of recurrent laryngeal nerve injury in esophageal cancer surgery

食管癌患者淋巴结转移率高,其中双侧喉返神经旁淋巴结转移率高达19.8%~37.6%。在食管癌根治性淋巴结清扫过程中,喉返神经旁淋巴结的清扫可改善预后,同样也会增加喉返神经损伤风险,导致患者术后出现声音嘶哑及肺炎等并发症,降低术后生活质量。需要术者注重喉返神经的保护,完善术前检查,确定手术流程,合理使用术中仪器,提高术中操作水平。本文就术中神经检测、手术方式、淋巴结清扫范围、术者个人因素、喉返神经旁淋巴结的检查方式等对术中喉返神经损伤的影响展开综述。

The rate of lymph node metastasis in patients with esophageal cancer is high,and the rate of bilateral recurrent laryngeal nerve lymph node metastasis is as high as 19.8%~37.6%.In the process of radical lymph node dissection for esophageal cancer,the dissection of lymph nodes adjacent to the recurrent laryngeal nerve can improve the prognosis,and also increase the risk of recurrent laryngeal nerve injury,resulting in complications such as hoarseness and pneumonia after operation,and reducing the quality of life after operation.It is necessary for the surgeon to pay attention to the protection of the recurrent laryngeal nerve,improve the preoperative examination,determine the surgical procedure,use the intraoperative instrument reasonably,and improve the intraoperative operation level.This article reviews the effects of intraoperative nerve detection,surgical methods,lymph node dissection range,surgeon's personal factors,and examination methods of lymph nodes adjacent to the recurrent laryngeal nerve on intraoperative recurrent laryngeal nerve injury.