The Significance Of Bilateral Central Lymph Node Dissection For Unilateral Papillary Thyroid Carcinoma

Objective:On patients with unilateral thyroid papillary carcinoma of lateral lymph node metastasis in central region and the correlation of different factors, for the clinical operation for patients with unilateral thyroid papillary carcinoma selection provides the basis.Methods:According to the inclusion criteria to select 2015- June 2015-4 month in fujian medical university union hospital blood vessels thyroid surgical treatment by the same set of thyroid surgery, postoperative pathology confirmed 70 cases of unilateral thyroid papillary carcinoma, analyze the clinical data, and the whole group, all patients accept unilateral thyroid gland + of + double side(VI) lymph node in central region were performed.Results:1.Lymph node metastasis rate was 75.7%(53/70) in central region as a whole. Overall unilateral thyroid cancer contralateral central transfer rate was 24.3%(17/70). Men unilateral thyroid papillary carcinoma and women unilateral thyroid papillary carcinoma of the contralateral central lymph node metastasis rate was 36.4%(8/22) and 18.8%(9/48), above the stage T3(T3) of unilateral thyroid papillary carcinoma and stage T3 under unilateral thyroid papillary carcinoma of the contralateral central lymph node metastasis rate was 25.0%(9/36) and 23.5%(8/34), one small thyroid papillary carcinoma with unilateral tiny thyroid papillary carcinoma of the contralateral central lymph node metastasis rate was 19.2%(9/47) and 34.8%(8/23), the left side of the papillary thyroid carcinoma and thyroid papillary carcinoma on the right side of the contralateral central lymph node metastasis rate was 31.0%(9/29) and 19.5%(8/41), unilateral multifocal papillary thyroid carcinoma with single focal unilateral thyroid papillary carcinoma of the contralateral central lymph node metastasis rate of 31 respectively, 3 %(5/16) and 22.2%(12/52), with central lymph node metastasis positive unilateral thyroid papillary carcinoma and cancer metastasis negative lymph node in central region of unilateral thyroid papillary carcinoma of the contralateral central lymph node metastasis rate was 34.29%(12/35) and 14.29(5/35).2.In patients with unilateral thyroid papillary, lateral lymph node in central region had metastasis are independent risk factors of lateral lymph node metastasis in central region, and gender, age, tumor diameter, number of lesions, lesion location(left side) and tumor T stage and the contralateral central region is no obvious correlation with lymph node metastases.3.The number of lymph node in central region conforms to normal distribution.4.All patients did not appear postoperative bleeding again. All patients in 1 case(1.4%, 1/70) patients tone down. All patients intraoperative nerve continuity are in good condition, 5 cases(7.1%, 5/70) of patients in the first postoperative day appear hoarse, 2 months after review sounds are back to normal. All patients were not a permanent laryngeal recurrent nerve paralysis. All appear on the first day postoperatively in patients with whole set of PTH decreased, compared with preoperative by an average 43.0%, including 4 cases(5.7%, 4/70) PTH levels are lower than normal, and hypocalcemia symptom such as tetany, to active calcium after symptomatic treatment of symptoms, such as 2 weeks after the review of PTH can be maintained at normal levels. Whole group of patients after the first day of an average of 54.83 ml, whole groups of patients were pulling the neck drainage tube 1 weeks after surgery, all patients no lymphatic leakage occurred.5.The whole group of patients because follow-up time is short, unable to evaluate the incidence of postoperative recurrence, remains to be further follow-up.Conclusion:1.In patients with ipsilateral lymph node metastasis in Central Line should be regular bilateral clean lymph node in central region.2.For lateral lymph node metastasis in central region with age, tumor diameter, the correlation of tumor T stage, number of lesions to enlarge sample size for further observation.3.The number of lymph node in central region conforms to normal distribution.4.If the skilled performer surgery, bilateral clean lymph node in central region does not increase the risk of complications.