中国甲状腺手术中喉返神经监测的使用情况:点流行率调查(2015-2023年)。

IF 12.5 2区 医学 Q1 SURGERY International journal of surgery Pub Date : 2024-09-06 DOI:10.1097/JS9.0000000000002084
Yishen Zhao, Peiyao Wang, Gianlorenzo Dionigi, Jiedong Kou, Changlin Li, Fang Li, Tie Wang, Wen Tian, Kewei Jiang, Ping Wang, Hao Zhang, Hui Sun
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引用次数: 0

摘要

背景:该调查旨在阐明中国甲状腺手术中使用术中神经监测(IONM)的全部国家实践,包括所有技术和非技术方面,以及手术分层和成熟度:中国神经监测研究组(CNMSG)在2015年至2023年期间编制了6份全国性调查问卷,用于收集和分析中国医疗机构与术中神经监测相关的临床应用、教育和科研等方面的数据:在接受调查的医院中,45%的医院年均手术量超过3000例,82.5%的医院80%以上的手术都是针对甲状腺恶性肿瘤。此外,97.5%的医院报告的术中信号丢失率(LOS)为500 µV,70%的医院报告的术中信号丢失率(LOS)为结论:IONM与年手术量呈独立递增关系。这项调查强调了全国性合作和/或登记对于接受、巩固和发展 CNMSG 共识的重要性。
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Utilization of recurrent laryngeal nerve monitoring during thyroid surgery in china: a point prevalence survey (2015-2023).

Background: The survey aimed to elucidate the complete range of national practices, including all technical and non-technical aspects, as well as surgical stratification and maturation, of the use of intraoperative neuromonitoring (IONM) during thyroid surgery in China.

Materials and methods: Six national questionnaires, developed by the Chinese Neural Monitoring Study Group (CNMSG) between 2015 and 2023, were used to collect and analyze data regarding the clinical application, education, and scientific research related to IONM in Chinese medical institutions.

Results: Among the surveyed hospitals, 45% reported an average annual surgical volume exceeding 3,000 cases, with 82.5% performing more than 80% of the surgeries for malignant thyroid tumors. Additionally, 97.5% of the hospitals reported a<3% incidence of postoperative hoarseness with IONM. Statistical analysis from 2011 to 2015 found that the incidence of postoperative hoarseness decreased by 30% in 2013 compared with 2011, when the technology was introduced. Preoperative and postoperative laryngoscopies were routinely performed by 82.5% and 15% of the hospitals, respectively. For 65% of the hospitals, the publication of the Chinese edition of neuromonitoring guidelines in 2013 prompted the utilization of IONM technology. An average annual number of IONM applications exceeding 500 cases (18.5% the average volume) was reported by 80% of the hospitals, while 62.5% reported a cumulative number of applications greater than 5,000 cases (47.1% the average cumulative volume). Regarding technical parameters, 75% of the hospitals reported an intraoperative V1 amplitude of >500 µV, and 70% reported an intraoperative loss of signal (LOS) rate of<3%. 92.5% of the surveyed hospitals believed that IONM could help identify dissociated nerves, and 95% of the surveyed hospitals believed that IONM could reduce nerve damage. However, 72.5% of the respondents thought that cost was the main limitation. Furthermore, 67.5% of the hospitals reported that half of their thyroid surgical team members were trained in IONM, with 17.5% reporting that all team members were trained. Areas for reinforced training included IONM research methods and directions (72.5%), and analysis and treatment of abnormal EMG signals (72.5%). Research projects related to IONM were conducted by 42.5% of the hospitals, while 52.5% had published papers on neuromonitoring.

Conclusions: IONM was independently and incrementally associated with the annual surgical volume. This survey emphasized the importance of national collaboration and/or a registry for the uptake, consolidation, and development of CNMSG consensus.

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来源期刊
CiteScore
17.70
自引率
3.30%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.
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