Résumé
Objective Previously, there was an argument on the surgery way of unilateral papillary thyroid microcarcinoma(PTMC).The purpose of this study was to investigate the predictive factors of occult thyroid carcinoma in unilateral thyroid papillary microcarcinoma, and to compare the surgical methods of unilateral thyroid papillary microcarcinoma.Methods We retrospective analyzed 327 cases of unilateral PTMC patients confirmed by preoperative color Doppler ultrasound examination from January 2014 to January 2016 in Department of Breast Surgery, First Affiliated Hospital of Harbin Medical University.According to the presence of occult cancer, patients were divided into unilateral glandular foci (n=278) and bilateral glandular foci(n=49);according to whether carry out the prevention of central lymph node dissection, patients were divided into lymph node dissection(n=117) and without lymph node dissection(n=210) to further analyze the predictive factors of contralateral gland occult cancer and postoperative complications of preventive central lymph node dissection.Results 55 cases had central lymph node metastasis in 117 cases with lymph node dissection, the metastasis rate was 47.0%.The multiple foci in the ipsilateral gland is a risk factor for the presence of occult foci in the contralateral gland (OR=4.924, 95%CI: 1.605~15.107).There was no significant difference in postoperative complications between lymph node dissection and without lymph node dissection(P>0.05).Conclusion multiple foci in the unilateral thyroid papillary thyroid microcarcinoma can help us to predict the contralateral gland occult cancer, and the central lymph node metastasis rate is higher, therefore, for the unilateral glands of multiple tumors in the papillary thyroid microcarcinoma, we recommended the total thyroidectomy+prophylactic central lymph node dissection surgery way.
Résumé
Thyroidectomy is an effective treatment for thyroid diseases,especially thyroid malignancies.The postoperative phonological disturbances in patients with recurrent laryngeal nerve injury caused by vocal cord paralysis have been recognized.However,in clinical work,many patients in the absence of recurrent laryngeal nerve injury in the case of postoperative speech changes.With the development of modern electronic acoustics detection technology,the quality of postoperative recurrent laryngeal nerve injury patients with quantitative research,to explore and found that recurrent laryngeal nerve injury after thyroid surgery is not the voice of the factors.