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Objective To explore central lymph node metastasis (CLNM) of cN0 papillary thyroid carcinoma(PTC).Methods We evaluate the clinical data of 245 patients with cN0 unilateral TPC undergoing total thyroidectomy and bilateral central lymph node dissection.Results Central lymph node metastasis of cN0 TPC was 36.8％ (91/245),significantly related to gender(x2 =5.626,P =0.018),age (x2 =6.255,P =0.012),tumor size (x2 =20.063,P ＜ 0.001) and capsule invasion (x2 =15.024,P ＜ 0.001).The central lymph node metastasis was 51.7％ (60/116) in 116 patients with tumor size ＞ 1 cm,and the contralateral CLNM was 22.4％ (26/116) which was related to capsule invasion (x2 =9.737,P =0.002) and delphian LNM(x2 =10.982,P =0.001) There were 6 cases (2.4％) suffering from temporary unilateral recurrent laryngeal nerve injury.96 cases (39.2％) suffered from temporary hypoparathyroidism and 3 cases (1.2％) from permanent hypoparathyroidism.The median follow-up time was 40 months.6 cases were found regional lymph node recurrence on the ipsilateral side.Tumor size ＞ 1 cm was significantly related with recurrence (P =0.008),as CLNM with higher recurrence rate (P =0.001).Conclusions CLNM is common in cN0 PTC patients,and central lymph node metastases increase the risk of recurrence.Prophylactic bilateral central lymph node dissection is suggested for tumor size ＞ 1 cm cases.
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Objective To study the clinical significance of recognizing Zuckerkandl tubercle (ZT) during thyroid surgery. Methods One hundred and sixty-one patients (218 sides) having underwent thyroid lobectomy or thyroidectomy were retrospectively analyzed. The presence of ZT, the position and size of ZT, and the relationship between ZT and recurrent laryngeal nerve (RLN), superior parathyroid (SP) were observed. Results In 218 sides, 179 sides (82.1%) found ZT, with right side in 93 cases and left side in 86 cases. The main relationship between ZT and RLN was A type, accounting for 90.5%(162/179). There were no statistical differences in ZT grade and the relationship type between ZT and RLN between left side and right side (P>0.05). There was negative correlation in ZT grade and the relationship type between ZT and RLN (r=-0.269, P<0.01). In right side, 92.3%(72/78) of SP located on the top of ZT at 10-11 o′clock position;in left side, 94.6%(70/74) of SP located on the top of ZT at 1-2 o′clock position. Conclusions ZT is an important anatomical mark in the thyroid surgery, which helps to identify and protect the RLN and SP, so as to reduce surgical complications.
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Objective To study the academic level of randomized control trials(RCTs)published from 2004 to 2009 in Chinese Journal of Hepatobiliary Surgery.Methods Published work about RCTs in 72 issues of Chinese Journal of Hepatobiliary Surgery was searched by finding relevant articles published during 2004-2009.Correlated indexes including literature received time, literature publishing time, the total number of citations, number of citations in Chinese, number of citations in English, research funding situations, the number of authors, article affiliations in all RCTs, together with single(or multiple)center study situation, positive conclusions, the starting time, the end time,and number of patients recruited in clinical RCTs were extracted for aggregate analysis.Results During the past six years, a total of 135 articles of RCT were published in Chinese Journal of Hepatobiliary Surgery, accounting for 8.7% in all clinical studies.The average number of RCTs in each issue was 1.88.The average time for publishing time delay was 450 days.The total number of citations in RCTs was 1252 and the average number of RCTs for citations was 9.3.53 RCT studies were financed, accounting for 39% of the total number of research papers.Beijing Friendship Hospital attached to the Capital University of Medical Sciences had published 8 papers of RCT and it is the institution of publishing the largest number of such papers in the journal.The number of multi-center study for RCTs was one and all RCT studies had significant conclusions.The average research duraton in RCTs was 45 months.The total number of patients in 33 clinical RCTs was 2705 and the average number of patients recruited in each RCT was 82.Conclusion Chinese Journal of Hepatobiliary Surgery put emphasis on the strongest evidence and the most valuable RCT researches that have great significance in the field of domestic hepatobiliary surgery for clinical treatment and experimental research.