Intraoperative neuromonitoring in traditional and miniinvasive thyroidectomy. A single center experience in 1652 nerve at risk

Background: The world is rapidly urbanizing, causing alarming health problems to their citizens. The Cities Changing Diabetes program aims to address the social factors and cultural determinants that can increase type 2 diabetes (T2D) vulnerability among people living in cities. Methods: Public data of Italian Institute for Statistics (ISTAT) and available scientific reports were reviewed and findings integrated. The prevalence of T2D in the 8 health districts of Rome was mapped and the correlation between prevalence and social and cultural determinants was assessed. Results: The metropolitan area of Rome has 4.3 million inhabitants. People over 65 has increased by 136,000 units in the last decade, reaching 631,000 citizens in 2015. Elderly people living alone are 28.4%. The obesity prevalence is 9.3%, as compared to 8.2% in the year 2000. The prevalence of T2D is 6.6%, varying in the different 8 health districts between 5.9% and 7.3%. A linear correlation exists between the prevalence of diabetes in the districts, unemployment rate and use of private transportation rate (Pearson R 0.52 and 0.60, respectively), while an inverse correlation is present with aging index, school education level, and slow mobility rate (Person R -0.57, -0.52, and -0.52, respectively). Conclusions: Important socio-demographic changes have occurred in Rome during the last decades with a raise in the prevalence of obesity and diabetes. A wide variation exists in the prevalence of T2D among the districts of Rome, associated with social and cultural determinants. This study model can help rethinking diabetes in an urban setting. (www.actabiomedica.it)

[1]  P. Del Rio,et al.  IONM and minimally invasive videoassisted thyroidectomy. , 2018, Il Giornale di chirurgia.

[2]  Wuzhen Chen,et al.  Protective Effects of Intraoperative Nerve Monitoring (IONM) for Recurrent Laryngeal Nerve Injury in Thyroidectomy: Meta-analysis , 2018, Scientific Reports.

[3]  M. Bolanowski,et al.  A functional assessment of anatomical variants of the recurrent laryngeal nerve during thyroidectomies using neuromonitoring , 2017, Endocrine.

[4]  Y. J. Chai,et al.  Medico-Legal Issues of Intraoperative Neuromonitoring in Thyroid Surgery , 2017 .

[5]  C. Lombardi,et al.  Neuromonitoring in endoscopic and robotic thyroidectomy , 2017, Updates in Surgery.

[6]  H. Dralle,et al.  Continuous intraoperative neural monitoring of the recurrent nerves in thyroid surgery: a quantum leap in technology. , 2016, Gland surgery.

[7]  P. Del Rio,et al.  Intraoperative neuromonitoring in thyroidectomy: the learning curve. , 2016, Annali italiani di chirurgia.

[8]  I. Ioniță,et al.  Intraoperative Monitoring of the Recurrent Laryngeal Nerve During Thyroidectomy , 2015 .

[9]  F. Chiang,et al.  Influence of intravenous anesthetics on neuromonitoring of the recurrent laryngeal nerve during thyroid surgery , 2014, The Kaohsiung journal of medical sciences.

[10]  Peter Angelos,et al.  Intraoperative Monitoring of the Recurrent Laryngeal Nerve during Thyroidectomy: A Standardized Approach Part 2 , 2012 .

[11]  P. Pisani,et al.  Minimally invasive video-assisted thyroidectomy (MIVAT): what is the real advantage? , 2010, Langenbeck's Archives of Surgery.