Clinical Application Of The Central Compartment Neck Dissection For Papillary Thyroid Microcarcinoma

Objective To investigate the papillary thriod mi-crocarcinoma( PTMC) surgery and to evaluate the significance of the same period resect the selective central neck lymph . observation of thyroid papillary microcarcinoma incidence of cervical lymph node metastases, factors that affect the neck lymph node metastasis and complications of the central neck lymph node after operation.Methods A retrospective analysis of Affiliated hospital of NingXia Medical University of 120 Patients with thyroid micarcinoma treated Between January 1st, 2009 to September 15th,2010 in our hospital . In this 120 patients of thyroid micarcinoma, there are 48 patients got ipsilateral lobectomy + resect isthmus, 33 had ipsilateral lobectomy plus contralateral isthmus resection and partial resection of the opposite side , 34 had total thyroidectomy, subtotal resection in 3 cases. Treatment of lymph nodes: in this group, 50 patients had lymph node dissection of central group , 14 patients underwent functional neck dissection, the remaining 56 cases without lymph node dissection. Lymph node dissection after the delivery and adipose tissue pathology, statistics, and lymph node metastasis, lymph node metastasis related factors, observe the early complications .Results 50 patients had lymph node dissection of central group have 22 cases of patients with cervical lymph node metastasis, the transfer rate of 44.0%, 14 patients with functional neck dissection in patients with lateral neck area in 7 patients had lymph node metastasis, when the lateral neck lymph nodes metastasis central region associated with lymph node metastasis in 6 cases. In this group there is no happen permanent postoperative complications, 50 cases of selective Central District lymph node dissection in patients with temporary hypoparathyroidism in 3 cases, temporary recurrent laryngeal nerve injury in 1; not line neck lymph node dissection in 56 patients postoperative transient hypoparathyroidism in 3 cases, temporary recurrent laryngeal nerve injury in 1, esophageal fistula in 1 case. The statistical analysis showed that: a selective line of the Central Region surgery and a surgical lymph node dissection lymph node dissection in patients without the line does not increase compared to the incidence of surgical complications (P = 1.000). Central District, lymph node metastasis and primary tumor capsule related violations; but not with tumor size and tumor number and the number has nothing to do with age. All Patients were followed uP from 6 to 27 months .all patients after operation oral Levothyroxine sodium tablets, According to TSH level regulate drags level.Conclusion 1 a selective line of conventional surgery dissection central region does not increase the surgical complication rate. 2,side of the gland increases PTMC Unilateral isthmus resection, bilateral PTMC underwent total thyroidectomy and routine elective neck dissection is the central region is an effective treatment of surgical PTMC. 3,central region related Violations of coating and not related Age,focus size and the number of tumor.