Surgical safety analysis of retained glands for micro-papillary thyroid carcinoma / 中国综合临床

ABSTRACT

Objective To study the surgical safety of retained glands for micro?papillary thyroid carcinoma(mPTC). Methods A total of two hundred patients with mPTC from June 2012 to June 2016 in Seventh People's Hospital of Shanghai University of TCM were enrolled in this study single follow?up group (group A,40 cases),unilateral total lobectomy+isthmus resection group(group B,85 cases),unilateral total lobectomy+contralateral lobe subtotal resection group( group C,45 cases) ,bilateral total lobectomy ( group D,30 cases) ,then the clinical outcome was compared. Results The average follow?up time was about 26. 5 months, and there was no significant increase in tumor diameter in group A ( (6. 6±1. 5) mm vs. (6. 5±1. 3) mm,t=0. 326,P=0. 621) . The incidences of hypothyroidism in group B and C were significantly lower than that in group D ( 7. 1％ vs. 30. 0％,χ2 =8. 366, P=0. 004, 11. 1％ vs. 30. 0％,χ2 =4. 230, P= 0. 040 ) , while the differences in hypoparathyroidism,hypocalcemia,laryngeal nerve injury and total rate among group B,C and D were not statistically significant(P>0. 05). The median survival times in group B,C and D were significantly longer than that in group A (42. 2months,43. 5months,43. 6months vs. 32. 8months,P<0. 05),while there was no significant difference among group B,C and D ( P>0. 05) . There was no statistically significant difference in 3?year tumor mortality and recurrence rates among the three groups ( P>0. 05 ) . Conclusion Unilateral lobe resection + isthmus resection + ipsilateral central lymph node dissection can maintain the gland function,reduce complications,without reducing the survival,it is worthy of popularization and application.