Aim: To clarify risk factors and long-term progress of postoperative recurrent laryngeal nerve paralysis (PRNP) in patients with esophageal cancer. Patients and Methods: One hundred and twenty-five esophageal cancer patients, who underwent subtotal esophagetomy, including recurrent laryngeal nerve lymphadenectomy, were analyzed. A laryngoscopy was routinely performed to assess the motility of vocal cords. Results: PRNP was detected in 79 patients and 26 (20.8%) patients required medical interventions (Grade II or more by the Clavien-Dindo classification; group II). Forty-one of 66 (62.1%) patients recovered from PRNP with a median postoperative time of 135 days. The three-field lymphadenectomy and long operative time were the independent prognostic factors of group II. Conclusion: Radical operation caused PRNP with grade II or more. The long-term follow-up of vocal cords was necessary to detect patients with either transient or permanent PRNP.
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