ABSTRACT
Monitoring with intraoperative Transesophageal Echocardiography (TEE) has proven to be a tool of very high utility for both control of the hemodynamic status, cardiac function and to make new diagnoses. It is a minimally invasive technique and, like any medical procedure, it is not exempt from complications that do not exceed 1%. These range from mild oropharyngeal lesions to the most serious lesion, esophageal perforation. We describe a case of esophageal perforation from the esophagogastric junction to the middle third of the esophagus in the intraoperative period of laparoscopic Nissen surgery. The injury was repaired immediately and the closure of the lesion was verified with pneumatic maneuvers through the nasogastric tube. The patient was discharged after 35 days
El monitoreo con Ecocardiografía Transesofágica intraoperatorio (ETE) ha demostrado ser una herramienta de muy alta utilidad tanto para control del estado hemodinámico, función cardíaca y para realizar nuevos diagnósticos. Se trata de una técica seiinvasiva y como todo procedimiento médico no está exento de complicaciones que no superan al 1%. Estas son desde lesiones leves orofaríngeas hasta la lesión más grave que es la perforación esofágica. Se describe un caso de perforación esofágica con desgrarro de éste desde la unión esofagogástrica hacia el tercio medio del esófago en el íntraoperatorio de cirugía de Nissen laparoscópico. La reparación de la injuria se realizó en forma inmediata y se comprobó con maniobras neumáticas a través de la sonda nasogástrica el cierre de la lesión. La paciente fue dada de alta a los 35 días.
Subject(s)
Humans , Male , Aged , Monitoring, Intraoperative/adverse effects , Echocardiography, Transesophageal/adverse effects , Esophageal Perforation/surgery , Esophageal Perforation/etiologyABSTRACT
PURPOSE OF REVIEW: Laryngeal nerve injuries are among the most important complications of thyroidectomy. Recently, the use of neuromonitoring has been increasingly employed in order to predict and document nerve function at the end of thyroidectomy. RECENT FINDINGS: There is much controversy in recent studies concerning neuromonitoring in thyroid surgery. Some authors believe that the method does not bring any additional reduction in the paralysis rate of the laryngeal nerves. Other researchers defend its use only in selected cases and in very specific situations. Finally, some much respected surgeons advocate the routine use of neuromonitoring in all thyroidectomies. SUMMARY: In this review, we try to present relevant recent publications dealing with this still controversial subject, emphasizing the advantages and disadvantages of neuromonitoring in thyroidectomy.