Erschienen in:
01.05.2013
Intention To Treat Analysis: Are We Really Doing It?
verfasst von:
Debajyoti Mohanty, Pankaj Kumar Garg, Anjay Kumar
Erschienen in:
World Journal of Surgery
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Ausgabe 5/2013
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Excerpt
We have read the article on visualizing the external branch of the superior laryngeal nerve during thyroidectomy by Barczynski et al. [
1] with great interest. The trial was conducted in a high-volume endocrine surgery center, which is evident from the fact that 517 patients were referred for thyroid surgery during the study period of 42 weeks (almost 12–13 patients per week). It would be interesting to know the prevalence of thyroid disease in their local area. The study included 210 female patients who were having goitre of size <100 ml, and they were treated with total thyroidectomy. The authors excluded male patients. The reason for this exclusion is not clear to us. We believe that the chance of events involving the external branch of the superior laryngeal nerve (EBSLN) in these patients is no different from that in the entire study population. Inclusion of all patients with large goiters and a past history of thyroid surgery, followed by a subgroup analysis, would have shown more valid results of intraoperative nerve monitoring (IONM) for identifying EBSLN in difficult cases. The significant effects of IONM may have been nullified by including small goiters. Also, first-time surgery with direct visualization often helps with satisfactory identification of EBSLN in these patients. …
