Thyroidectomy With Recurrent Laryngeal Nerve Envelopment in Thyroid Cancer Surgery

Background. According to the American Thyroid Association National Cohort Study (2016–2021), the reoperation rate is 14.2% for early postoperative complications in hemithyroidectomies; 1.7% is for late postoperative complications in hemithyroidectomies; 0.2% is for early postoperative complications in thyroidectomies; 0.3% are for late postoperative complications in thyroidectomies. In the cases of repeated thyroid surgeries, especially in patients with malignant neoplasms after lymph node dissection, the risk of postoperative recurrent laryngeal nerve paresis increases 4.6 to 10.4 times compared to the primary operation. Clinical Case Description. The article presents a clinical case of thyroidectomy using recurrent laryngeal nerve envelope for papillary cancer of the stage III left lobe of the thyroid gland T3N0M0. To perform bilateral enveloping of the recurrent laryngeal nerve, its bilateral fixation on the holders was performed, after which bilateral enveloping of the nerve was performed according to the "muff" type with two patches. A 2 cm long autovein for patches was taken from the distal branch of the great saphenous vein in the lower leg using a minimally invasive approach. The early postoperative period was uneventful, the patient was discharged in a satisfactory condition. In the late postoperative period, when monitoring was conducted, complications that affected quality of life were not detected. Conclusion. Therefore, the envelope of the recurrent laryngeal nerve using an autovein appears to be a promising method to prevent damage to the recurrent laryngeal nerve during repeated thyroid surgeries in patients with malignant thyroid diseases.