Clinical Analysis Of Reoperation For Recurrent/persistent Papillary Thyroid Carcinoma

Objective:This study aimed to analyze the causes of reoperation for papillary thyroid carcinoma(PTC)and summarize experience to reduce avoidable reoperations.Methods : We retrospectively studied 60 patients with PTC who underwent reoperation in the Endocrine and Breast Surgery Department of the First Affiliated Hospital of Chongqing Medical University from January2013 to December 2017.Results:Of the 60 PTC patients included in this study,11(18.3%)had lymph node metastasis(LNM)in the central plus lateral compartment of the affected side;34(56.7%)only had lymph node metastasis of the affected side compartment;There were 6(10.0%)metastasis to the lymph node posterior to right recurrent laryngeal nerve(LN-pr RLN);10(16.7%)patients had lymph node metastases in the contralateral compartment;We found that patients with recurrence after reoperation were older(P=0.003),the more number of lymph node metastases(LNMN)(P=0.037),and the thyroglobulin was higher before reoperation(P=0.034);and the multivariate analysis indicated that the LNMN in initial operation(OR=1.174,P=0.008),age(OR=1.130,P=0.014)and Tg level before reoperation(OR=1.156,P=0.040)were all independent predictors for recurrence after reoperation.Conclusion:Local lymph nodes recurrence/persistence is the main reason for reoperation in our study.The LNM of the initial operation and age affect the prognosis after reoperation;Reoperation is difficult and risky,and attention should be paid to the protection of parathyroid glands and recurrent laryngeal nerve.