The Clinical Investigation On Total Thyroidectomy In The Treatment Of Differentiated Thyroid Carcinoma

Objective Differentiated thyroid carcinoma accounts for most of the cancer, its degree of malignancy is not high, and the biological behavior is relatively inert, so the scope of its removal still be controversial at home and abroad for many years. In recent years, total thyroidectomy surgery to treat the differentiated thyroid carcinoma gradually became the mainstream, but it is difficult to perform surgical operations, postoperative complications are more common, and it is reported that serious consequences of the complications are more painful than survival with the carcinoma. This paper analyzed and concluded differentiated thyroid carcinoma thyroidectomy cases in our hospital, and analyzed the application of"the meticulous capsular dissection technique"in differentiated thyroid carcinoma. The aim of this paper is to discuss the indications and operating skills of total thyroidectomy surgery, and advantages of the " the meticulous capsular dissection technique ". In addition, we strive to reduce the complications after total thyroidectomy, in particular, to reduce the recurrent laryngeal nerve and parathyroid injury, and eventually improve the patient's quality of life.Methods (1) Make a retrospectively analysis and summary of 53 cases with differentiated thyroid carcinoma Total Thyroidectomy in our hospital between January 2001 ~ January 2010. (2) Make a retrospectively analysis and summary of 283 cases with postoperative complications of differentiated thyroid carcinoma implementing subtotal resection between January 2007 ~ January 2010. Statistical analysis using statistical software SPSS11.5 assisted analysis.Results Total thyroidectomy in patients with 13 cases of male and female patients with 40 cases of male to female ratio of 1:3.08, aged 11 to 71 years, with an average age of 49.28 years, of which 35 cases the initial surgery, postoperative hoarseness and postoperative hypocalcemia in 4 cases, The incidence was 11.4%; second or multiple surgery in 18 cases, postoperative hoarseness and postoperative hypocalcemia in 7 cases, the incidence of 38.9%, re-or multiple-surgery patients compared with patients more likely to have surgery after the initial hoarseness and low - calcium (P = 0.048). The patients with differentiated thyroid carcinoma, " the meticulous capsular dissection technique " after short-term complications such as hoarseness and calcium was significantly lower than the likelihood of the outer envelope of traditional dissection (P = 0.024).Conclusion Total thyroidectomy in the treatment of differentiated thyroid cancer in the existence of a higher incidence of complications, especially in patients with secondary or multiple operations to be strictly controlled surgical indications, following the principle of individual treatment, through the surgery fine operation, in particular, used the term " the meticulous capsular dissection technique " can reduce the total thyroidectomy complications, so that patients benefit from indications.