关键词: 预防性颈部淋巴结清扫术, 甲状腺全切术, 甲状腺微小乳头状癌

Abstract:

Objective    To explore factors influencing the metastasis of lymph nodes in clinical analysis negative (cN0)  papillary thyroid microcarcinoma and to analyze the value and feasibility of total thyroidectomy and prophylactic lymph node cleaning in Ⅶ）Ⅵ, Ⅲ and Ⅳ(+)Ⅱ. Methods    The clinical statistics of 162 patients with cN0 papillary thyroid microcarcinoma treated by total thyroidectomy and prophylactic lymph node cleaning in Ⅵ, Ⅲ and Ⅳ(+)Ⅱ in Jinan Military General Hospital from November 2008 to March 2012 were systemically retrospectively analyzed. Results    Of the 162 cases, 74 cases(74/162,45.7%) were positive in lymph node in which 71 cases(71/162,43.8%) happed in central line and 45 cases (45/ 162，29.6%) in lateral line III and Ⅳ(+)Ⅱ. The relative risk factors of neck lymph node metastasis in PTMC reside in age and invasion state of tumor capsule. There was only one single laryngeal recurrent nerve injury for tumor invasion. There was 1 case of breeding(0.62%), 2 hematoma(1.23%) and 59 temporary parathyroid function decline. All were cured after treatment. No permanent parathyroid gland damage happened. Conclusion    It is safe and of great important and operable probability to do the total thyroidectomy and VI neck lymph node cleaning (high risk including  Ⅲ, Ⅳ(+)Ⅱ) for cN0 PTMC.

Key words: Total thyroidectomy, Prophylactic lymph node cleaning, Papillary thyroid microcarcinoma