多功能保留颈清扫术治疗cN_(1b)期分化型甲状腺癌患者的疗效及对复发和并发症的影响

Effect of multifunctional neck-sparing dissection in the treatment of patients with cN_(1b) stage differentiated thyroid cancer and its impact on recurrence and complication

目的探讨多功能保留颈清扫术治疗cN_(1b)期分化型甲状腺癌患者的疗效及对复发和并发症的影响。方法将206例cN_(1b)期分化型甲状腺癌患者根据手术方案不同分为对照组113例(改良式颈清扫术)和观察组93例(多功能保留颈清扫术)。比较两组患者疗效、术后2年复发率及并发症总发生率。结果两组患者清扫的淋巴结总数及阳性淋巴结比较,差异均无统计学意义(P﹥0.05)。观察组患者复发率、并发症总发生率均低于对照组,差异均有统计学意义(P﹤0.05)。结论对cN_(1b)期分化型甲状腺癌患者采用多功能保留颈清扫术治疗,根治效果较好,可保留颈部功能,显著降低术后并发症发生率及复发率,临床应用前景广阔。

Objective To investigate the effect of multifunctional neck-sparing dissection in the treatment of patients with cN_(1b) stage differentiated thyroid cancer and its impact on recurrence and complication. Method A total of 206 patients with cN_(1b) stage differentiated thyroid cancer were divided into control group of 113 cases (modified neck dissection) and observation group of 93 cases (multifunctional neck- sparing dissection) according to different surgical procedures. The efficacy, two-year recurrence rate and the total incidence of complications were compared between the two groups. Result There were no significant differences in the total number of dissected lymph nodes and positive lymph nodes between the two groups (P>0.05). The recurrence rate and the total incidence of complications in the observation group were lower than those in the control group, and the differences were statistically significant (P<0.05). Conclusion The radical effect is better for patients with cN_(1b) stage differentiated thyroid cancer when using multifunctional neck-sparing dissection. This surgical method could preserve neck function, significantly reduce the incidence of postoperative complications and recurrence, and has broad prospects for clinical application.