Value of bilateral central neck dissection in patients with clinically node-negative papillary thyroid microcarcinoma / 中华内分泌外科杂志

Objective To study the risk factors of lymph node metastasis in the central neck compartment of thyroid carcinoma,and to explore the reasonable range of lymph node dissection in central neck dissection for clinically node-negative papillary thyroid microcarcinoma patients.Methods From Dec.2015 to Dec.2016,a total of 200 patients with CN0 papillary thyroid carcinoma were randomly divided into two groups according to the registration number:unilateral central neck dissection group and bilateral central neck dissection group in Department of Thyroid Surgery,Fujian Medical University Union Hospital.The risk factors of lymph node metastasis and value of bilateral central neck dissection were analyzed.Results The risk factors of lymph node metastasis in the central papillary thyroid carcinoma were ≥0.7 cm in diameter and older than 45 years in age and gender in male.Further analysis found that contralateral central lymph node metastasis occurred in patients with tumor diameter ≥0.5 cm.The positive rate was 22％.The number of lymph nodes detected in the unilateral and bilateral central areas was 9.53±6.04 and 12.19±7.18,P=0.035,respectively.The positive numbers of lymph nodes were 1.17±1.47 and 2.11±2.75,P=0,022 respectively.Conclusion In patients with tumor diameter ≥0.5 cm,bilateral central neck dissection is conducive to improving the thoroughness of tumor dissection and does not increase the risk of complications.

Application of central region cervical lymph nodes dissection in papillary thyroid microcarcinoma with clinically node-negative sides of neck stage / 中国医师进修杂志

Objective To analyze the application value of central region cervical lymph nodes dissection in papillary thyroid microcarcinoma (PTMC) with clinically node-negative sides of neck stage.Methods Clinical data of 72 PTMC patients with clinically node-negative sides of neck stage were collected,and they were underwent total thyroidectomy,isthmic portion excision and contralateral lobus glandularis excision and neck dissection.A long term follow-up was made.Results Twenty-four patients were found central region cervical lymph nodes metastasis while other 48 patients were not found central region cervical lymph nodes metastasis.Followed up for 1.5-4.5 (3.4 ± 1.1) years,4 patients were found recurrent laryngeal nerve paralysis and recovered within 4 months.Four patients were found central region cervical lymph nodes metastasis after operation the 3rd years.Conclusions There is a tendency for PTMC patients with clinically node-negative sides of neck stage to occur central region cervical lymph nodes metastasis,it's necessary to perform prophylactic central region dissection.It can decrease the complications and improve the prognosis.