Meta-analysis Of Complications After Lymph Node Dissection In The Central Region Of Stage Cn0 Micro Papillary Thyroid Carcinoma

Objective:At present,with the development of medical level such as imaging technology,more papillary thyroid microcarcinoma(PTMC)with diameter less than 1 cm has been discovered earlier.In this paper,the meta-analysis method was used to compare the postoperative complications of c N0 PTMC patients who underwent central lymph node dissection(p CLND)after surgical resection with those who underwent Total thyroidectomy(TT)or thyroidectomy(HT).Methods:In CNKI,ten thousand party database,Pub Med,EMbase,Webof Science,Chinese biomedical literature database retrieval,from building to since March 2021,the relevant of thyroid papillary carcinoma cleaning related literature on export of lymph node in central region,and through strict selection of literature quality and practical assessment,for eligible literature data extraction for meta analysis.The difference in outcome indexes between the central region lymph node dissection group and the conventional operation group was analyzed and compared in domestic and foreign population,such as Localrecurrence(LR),bleeding,infection,temporary/permanent laryngeal recurrence nerve injury,temporary/permanent parathyroid function impairment.Results:A total of 8 eligible articles were included in this study,all of which were retrospective cohort studies,including 3448 PTMC patients,and 1254 patients received total thyroidectomy/thyroidectomy(TT/HT)+p CLND disease/cases.Accordi-ng to the results of Meta-analysis,compared with TT/HT group,1)TT/HT+p CLND group has a significant difference in local recurrence rate [OR = 0.39,95% CI(0.22,0.67),P = 0.0007] At the same time,the subgroup analysis of the population at home and abroad is statistically significant.2)The TT/HT+p CLND group and TT/HT group were bleeding [OR = 0.67,95% CI(0.24,1.89),P = 0.45] and infected [OR =1.61,95% CI(0.49,5.33),P = 0.44] P = 0.034]/[or = 0.66,95%CI(0.25,1.70),p =0.38],long-term parathyroid dysfunction [[OR=1.68,95%CI(0.88,3.20),p = 0.12] 3)The TT/HT+p CLND group had statistical significance in short-term and temporary parathyroid dysfunction [[OR=1.90,95%CI(1.44,2.50),P < 0.00001].Although the incidence of TT/HT+p CLND group was higher,there was no statistical significance in the permanent parathyroid dysfunction after active calcium supplementation.Conclusion:In a comparative analysis of available data,total thyroidectomy/thyroid lobotomy(TT/HT)combined with central lymph node dissection reduced the risk of postoperative recurrence without increasing complications.