Efficacy of different surgical methods in the treatment of papillary thyroid carcinoma of the isthmus and their effects on parathyroid function and thyroglobulin / 中国基层医药

ABSTRACT

Objective:To investigate the therapeutic effects of different surgical methods on papillary thyroid carcinoma of the isthmus (PTCI) and their effects on parathyroid function and thyroglobulin.Methods:Eighty patients with PTCI who underwent treatment in Zhejiang Xin'an International Hospital from January 2016 to January 2021 were included in this study. They were randomly allocated to undergo ipsilateral lobectomy with removal of the isthmus combined with ipsilateral central neck lymph node dissection (group A, n = 40) or total thyroidectomy combined with ipsilateral central neck lymph node dissection (group B, n = 40). We compared intraoperative and postoperative conditions, complications, and hypoparathyroidism between the two groups. We also compared serum thyroglobulin level measured before and 3 days after surgery between the two groups. Results:Operative time was significantly shorter in group A than in group B [(78.95 ± 13.52) minutes vs. (104.23 ± 27.38) minutes, t = -5.23, P < 0.05]. Intraoperative blood loss was significantly less in group A than in group B [(52.32 ± 6.59) mL vs. (75.41 ± 9.98) mL, t = -12.21, P < 0.05]. There were no significant differences in voice handicap index and reflux symptom index scores between the two groups (both P > 0.05). The incidence of complications was significantly lower in group A than in group B (10.00% vs. 30.00%, χ2 = 5.00, P < 0.05). The incidence of hypoparathyroidism was significantly lower in group A than in group B (7.50% vs. 27.50%, χ2 = 5.54, P < 0.05). At 3 days after surgery, serum thyroglobulin level was significantly lower in group A than in group B [(0.82 ± 0.17) μg/L vs. (1.26 ± 0.23) μg/L, t = -9.73, P < 0.05]. Conclusion:Ipsilateral lobectomy with removal of the isthmus combined with ipsilateral central neck lymph node dissection is more effective on PTCI than total thyroidectomy combined with ipsilateral central neck lymph node dissection. The former has little effect on parathyroid function and can reduce serum thyroglobulin level. The study is highly innovative and scientific.