Analysis Of The Value Of Dissection Of Lymph Node Posterior To Right Recurrent Laryngeal Nerve In The Operation Of Papillary Thyroid Carcinoma

Objective: To explore the right laryngeal papillary thyroid carcinoma lymph node after recurrent laryngeal nerve(LN-prRLN) metastasis related risk factors, clinical value of surgical dissection in LN-prRLN.Methods: A retrospective analysis of 140 cases of breast surgery, First Affiliated Hospital of Chongqing Medical University from June 2014 to October 2015 the same endocrine therapy group were(on the right side, bilateral isthmus) report examined the disease clinical data of patients with thyroid cancer and postoperative surgery were performed by the same senior doctors, the basic operation mode for the right lobe resection of right lymph nodes dissection, intraoperative dissection alone LN-prRLN and pathologic examination, analysis of 140 cases of thyroid cancer patients with cervical lymph node metastasis and postoperative complications in 290 cases; at the same time to collect the clinical data of patients with thyroid cancer as the control group A(group I underwent LN-prRLN dissection 140 cases), B group(I group without LN-prRLN dissection 119 cases) and C group(the other group without LN-prRLN dissection 171 cases).Results: 140 cases of postoperative patients with pathologically confirmed were papillary carcinoma, which were follicular subtype, right cervical lymph node metastasis rate was 64.3%(90/140) and lymph node metastasis rate of 63.6%(89/140), LN-prRLN regional lymph node metastasis rate was 17.9%(25/140); postoperative emergence of hoarseness in 5 cases, chylous fistula in 5 cases, subcutaneous hematoma in 2 cases; single factor analysis showed that tumor > 1cm, tumor multiple, coated with invasion, clinical lymph node staging cN1,(a+c+b ’) correlation(P < 0.05) transfer and carotid region of lateral lymph node metastasis and LN-prRLN. Multivariate analysis showed that the presence of OR=4.599(P=0.037) and lateral cervical lymph node metastasis(OR=3.505, P=0.036) were risk factors for LN-prRLN metastasis. A, B, C three groups on the right side of central lymph node dissection and the number of transfer ratio had significant difference(P=0.0003).Conclusion: PTC patients on the right side of the central lymph node transfer rate is high, should be regular cleaning LN-prRLN to ensure the cleaning is complete and thorough, to the greatest extent reduce operation due to residual lymph node recurrence metastasis and underwent secondary surgery may; when the tumor > 1cm, tumor multiple, coated with invasion, clinical lymph node staging cN1,(a+c+b ’) and the lateral neck lymph node metastasis, should attach importance to LN-prRLN cleaning.