Complications After Different Operation Modes Analysis Of Differentiated Thyroid Carcinoma

Objective： Thyroid cancer is a thyroid neoplasm that ismalignant,accounting for1%to2%of the systemic cancer.Females are morelikely to have thyroid cancer.Thyroid cancers can be classified according totheir histopathological characteristics including papillary thyroid cancer,follicular thyroid cancer, medullary thyroid cancer, anaplastic thyroidcancer.The follicular and papillary types together can be classified as'differentiated thyroid cancer'. Differentiated thyroid cancer is slow-growing.Surgery has high cure rate.Range of initial surgery is an important factor toaffect the prognosis and recurrence of differentiated thyroid cancer.The ATArecommend total thyroidectomy to treat differentiated thyroid cancer and totalthyroidectomy can be used when the tumor diameter is greater than1cm.Inchina total thyroidectomy is still controversial.One of the reasons of thedispute is thyroidectomy treatment of differentiated thyroid cancer willincrease in postoperative complications.In this paper, analysis and comparisonof surgical complications after different operation modes.The complicationsinclude recurrent laryngeal nerve damage, hypocalcemia. Combined withpostoperative complication rate in China's hospitals of total thyroidectomywith non-total thyroidectomy to investigate optimal surgery of differentiatedthyroid carcinoma.Methods：Between2004-01and2012-01,316patients with differentiatedthyroid carcinoma were treated in the second hospital of Heibei MedicalUniversity. According to the different surgical procedures,they are divided intolobectomy group, lobectomy with contralateral subtotal thyroidectomygroup,total thyroidectomy group and total thyroidectomy with cervical lynphnode dissection group, Four groups were compared after surgicalcomplications of differentiated thyroid cancer,including recurrent laryngeal nerve injury and postoperative hypocalcemia.what's more there are fivehospital's data that collect from CNKI and CBM to investigate optimalsurgery of differentiated thyroid carcinoma.Results:1. Total thyroidectomy in50cases, postoperative hoarseness in2cases, the incidence of4%; total thyroidectomy and unilateral or bilateralneck dissection in52cases, among which postoperative hoarseness in6cases,the incidence of11.54%; ipsilateral thyroid lobe and isthmus resection in77cases,1cases after operation the hoarse voice, the incidence of1.30%; theipsilateral glandular lobe and isthmus with contralateral subtotal resection in137cases,4cases of postoperative hoarseness, occurred at a rate of2.92%;Thechi-square test, line total thyroidectomy and unilateral or bilateral neckdissection for recurrent laryngeal nerve injury rate is higher than the line ofthyroid lobe and isthmus resection and glandular lobe and isthmus withcontralateral subtotal hysterectomy. Total thyroidectomy recurrent laryngealnerve injury and thyroid lobe and isthmus resection and glandular lobe andisthmus with contralateral subtotal excision showed no statistical differences.2.total thyroidectomy in50cases, postoperative hypocalcemia in11cases, theincidence of22%; total thyroidectomy and unilateral or bilateral neckdissection in52cases, postoperative hypocalcemia in12cases, the incidenceof23.08%; ipsilateral thyroid lobe and isthmus resection in77cases,1casesappeared after operation hypocalcemia, occurred at a rate of1.30%; theipsilateral glandular lobe and isthmus with contralateral subtotal resection in137cases,9cases of postoperative hypocalcemia, occurred at a rate of6.54%;by chi-square test, whole thyroid lobectomy and total thyroidectomy andlymph node dissection postoperative hypocalcemia was significantly higherthan that of the thyroid gland and isthmus resection and glandular lobe andisthmus with contralateral subtotal hysterectomy total thyroidectomy and totalthyroidectomy and lymph node dissection postoperative hypocalcemia nostatistical difference. Conclusion:1For differentiated thyroid carcinoma, the incidence ofrecurrent laryngeal nerve injury increases with the increasing of the thyroidresection range, the incidence of recurrent laryngeal nerve injury after totalthyroidectomy with cervical lymph node dissection is higher than lobectomyand lobectomy with with contralateral subtotal thyroidectomy.2the incidence of postoperative hypocalcemia after total thyroidectomyis higher than lobectomy and lobectomy with with contralateral subtotalthyroidectomy.