Effect Of Different Neck Lymph Node Dissection On Papillary Thyroid Carcinoma

Objective:To investigate the effect of functional neck dissectio n and selective neck dissection on papillary thyroid carci noma.Methods:Selected 176 patients with thyroid papillary carcinoma who were undergoing thyroid surgery in Xinmin Hospital of China-Japan Union Hospital of Jilin University from June 2014 to December 2015 and preoperative assessment of cervi cal lymph node metastases Divided into functional neck cle ar group and selective neck clear group,88 cases in each,to perform the corresponding cervical lymph node dissecti on.Central lymph nodes were routinely cleaned.Functional neck clearing group: The cervical lymph node in the range of ? to ? was dissected,and the non-lymphoid structure(sternostmoid muscle,internal jugular vein,and accessor y nerves)was preserved;the selective neck dissection group: the scope of dissection was ?a,?,? cervical lymph n odes.Detailed records of general conditions,tumor charac teristics,number of lymph node dissections,incision leng th,intraoperative blood loss,operation time,hospital st ay,postoperative drainage volume,drainage time,complica tion rate,and postoperative recurrence pattern and recurr ence rate.Results:1.There was no significant difference in age,sex,sc ope of thyroidectomy,postoperative radioiodine 131 treatm ent,and tumor characteristics between the two groups(P>0.05),and they were comparable.2.In terms of the number of lymph node dissections,t here was no significant difference in the number of lymph nodes detected in the functional neck clear group and the selective neck clear group after operation(3.7 VS 3.5 pie ces).3.Compared with the functional neck dissection group,the selective neck dissection group had shorter operation time,shorter hospital stay,shorter incision,less intraoperative blood loss and postoperative drainage,and short er postoperative drainage time.Statistical significance(P<0.05).4.In terms of postoperative complications,the incide nce of accessory nerve injury was higher in functional nec k dissection than in selective neck dissection(5 cases of VS 0 cases,P=0.023<0.05),the difference was statistical ly significant;There was no significant difference in ble eding,incision infection,nerve injury(except for access ory nerves),lymphatic leakage,facial edema,etc.(P>0.05).5.The results of postoperative recurrence pattern and recurrence rate analysis showed that there was no signifi cant difference in recurrence pattern or recurrence rate b etween the functional neck clear group and the selective n eck clear group(P>0.05),among which the selective neck c lear group was only 1(1.1%)patients had recurrence of ly mph node metastasis(?b,? area)in the same side of the previous unsweeped area.Conclusion:1.The incidence of complications after elective nec k dissection is low;2.There was no difference in the recurrence rate o f selective neck dissection and functional neck dissectio n;3.There is no clinical significance for routine swe eping in zone ?b and ?;4.Selective neck dissection has a short operation t ime,simple operation,beautiful incision,and rapid posto perative recovery.