Abstract:Objective To investigate the effect comparison of preventive cervical central lymph node dissection and conventional total thyroidectomy in the treatment of thyroid cancer.Methods The clinical data from 50 patients with thyroid cancer who were admitted to our department from January 2007 to January 2012 were analyzed.According to different surgical methods,they were divided into control group(n=20,traditional total thyroidectomy)and observation group(n=30,preventive cervical central lymph node dissection).The operative time,intraoperative blood loss,incidence of temporary and permanant hypocalcemia,recurrence rate 5 years after surgery,incidence of postoperative cervical lymph node metastasis and survival rate in two groups were observed.Results The operative time in the observation group was longer than that in the control group.The intraoperative blood loss was more,the 5-year recurrence rate after surgery,postoperative cervical lymph node metastasis rate,and the survival rate were all lower compared with those in the control group.The differences were statistically significant(P<0.05).There was no significant difference in the incidence of temporary/permanent hypocalcemia between the two groups(P>0.05).Conclusion Preventive cervical central lymph node dissection for thyroid cancer patients can reduce the incidence of hypocalcemia and obtains a good prognosis,which is worthy of clinical application and promotion.
Tavares MR,Cruz JA,Waisberg DR,et al.Lymph node distribution inthe central compartment of the neck:an anatomic study[J].Head Neck,2014,36(10):1425-1430.
Wang TS,Evans DB.Commentary on:occult lymph node metastasis and risk of regional recurrence in papillary thyroid cancer after bilateral prophylactic central neck dissection:a multi-institutional study[J].Surgery,2017,161(2):472-474.
Ito Y,Fukushima M,Higashiyama T,et al.Incidence and predictors of right paraesophageal lymph node metastasis of N0 papillary thyroid carcinoma located in the right lobe[J].Endocr J,2013,60(3):389-392.
Pinyi Z,Bin Z,Jianlong B,et al.Risk factors and clinical indication of metastasis to lymph nodes posterior to right recurrent laryngeal nerve in papillary thyroid carcinoma:A single-center study in China[J].Head Neck,2014,36(9):1335-1342.
Giordano D,Valcavi R,Thompson GB,et al.Complications of central neck dissection in patients with papillary thyroid carcinoma:results of a study on 1087 patients and review of the literature[J].Thyroid,2012,22(9):911-917.
[17]
Wang LY,Versnick MA,Gill AJ,et al.LevelⅦ is an important component of central neck dissection for papillary thyroid cancer[J].Ann Surg Oncol,2013,20(7):2261-2265.