常规中央区淋巴结清扫在cN_0期分化型甲状腺癌根治术中的应用

Application of routine central lymph node dissection in radical operation of cN_0 stage differentiated thyroid carcinoma

目的:探讨常规中央区淋巴结清扫在cN_0期分化型甲状腺癌根治术中的应用。方法:将收治的cN_0期分化型甲状腺癌患者43例(50侧)随机分为清扫组(腺叶切除并淋巴结清扫)及非清扫组(腺叶切除),分别行或不行一期中央区淋巴结清扫,比较两组临床病理学参数。结果:清扫组手术时间、术中出血量高于非清扫组,局部复发率、颈侧方的淋巴结转移发生率低于非清扫组,两组差异有统计学意义(P<0.05)。两组术后并发症及5年生存率差异无统计学意义(P>0.05)。结论:对于cN_0期分化型甲状腺癌,常规进行中央区淋巴结清扫术在不增加手术并发症的基础上,有利于彻底清除隐匿转移的淋巴结,减少肿瘤复发,降低颈侧方的淋巴结转移发生率并改善存活率。

Objective：To study the effect of routine central lymph node dissection（RCLD） in radical operation of cN_0 stage differentiated thyroid carcinoma.Methods：A total of 43 cases surgical treatment cases（50 sides） of cN_0 stage differentiated thyroid carcinoma were randomly divided into lymph node dissection group（lobectomy and lymph node dissection） and non-lymph node dissection group（lobectomy）,respectively,with or without central lymph node dissection.Then,intraoperative and postoperative clinicopathological parameters for the two groups were compared.Results：Operation time,intraoperative blood loss in lymph node dissection group were higher than non-lymph node dissection group,local recurrence and lateral neck lymph node metastasis rate were lower than non-lymph node dissection group,they had statistically significant between two groups（P〈0.05）; postoperative complications and postoperative 5-years survival rate had no statistical significance between two groups（P〉0.05）.Conclusion：For cN_0 stage differentiated thyroid carcinoma,RCLD would not only be beneficial to eliminating occult lymph node metastases,but also reduce local recurrence and lateral neck lymph node metastasis rate without increasing complications.