title: Medicolegal implications of surgical errors and complications in neck surgery: A review based on the Italian current legislation.
abstract: Aim of the present paper is the review of the principal complications associated to endocrine neck surgery considering how expertise, full adoption of guidelines, appropriate technology and proper informed consent may limit the medicolegal claims at the light of the incoming new regulation of the medical professional legal responsibility. A literature search, using the Medline/PubMed database for full-length papers, was used. Postoperative recurrent laryngeal nerve (RLN) palsy and hypoparathy-roidism remain the principal causes of surgical malpractice claims . In the procedure of neck lymphadenctomy intra-operative haemorrhage, thoracic duct injury, injuries to loco-regional nerves can be observed and can be source of claims. After many years of increased medicolegal litigations, the Italian government is proposing a drastic change in the regulations of supposed medical malpractice in order to guarantee the patient's right to a safe treatment and in the meantime to defend clinicians from often unmotivated and prejudicial legal cases. Surgical errors and complications in neck surgery are a relevant clinical issue. Only the combination of surgical and clinical expertise, application of guidelines, appropriate technology and a routinely use of specific informed consent can contain potential medicolegal implications.
authors.affiliation: University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Polistena
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Di Lorenzo
authors.affiliation: University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sanguinetti
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Buccelli
authors.affiliation: Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Conzo
authors.affiliation: Department of Surgery, Radiology and Public Health, Public Health and Humanities Section, University of Brescia - Centre of Bioethics Research, Brescia, Italy.
authors.forename: Adelaide
authors.initials: A
authors.lastname: Conti
authors.affiliation: Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Niola
authors.affiliation: University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
keywords: Complications; Malpractice; Medicolegal claims; Neck lymphadenectomy; Parathyroidectomy; Thyroidectomy