Investigation of the surgical approach combined with frozen sections pathological features of papillary thyroid microcarcinoma
10.3760/cma.j.issn.1673-4203.2015.04.007
- VernacularTitle:结合冰冻病理特点探讨乳头状甲状腺微小癌的合理术式
- Author:
Wei YU
;
Huisheng YUAN
;
Shi CHENG
;
Jianwei ZHENG
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Recurrence;
Recurrent laryngeal nerve;
Cryoultramicrotomy
- From:
International Journal of Surgery
2015;42(4):236-239
- CountryChina
- Language:Chinese
-
Abstract:
Objective Investigate the reasonable surgical approach combined with frozen sections pathological features of papillary thyroid microcarcinoma.Methods Clinical data of 96 cases papillary thyroid microcarcinoma nearly 5 years of follow-up in our clinic referral was retrospectively analyzed.Metastasis and recurrence rate were compared between group of ipsilateral lobe plus isthmus resection (unilateral group) and group of ipsilateral lobe plus isthmus resection and contralateral lobe subtotal (bilateral group).Metastasis and recurrence rate were compared between group of central lymph node dissection (dissection group) and non-dissection group (non-dissection group),and the injury rate of the recurrent laryngeal nerve was also compared between the two groups.Results The diagnosis of cancer by intraoperative frozen pathology were 53 cases (55％).Whether in high or low risk populations,the metastasis and recurrence between unilateral and bilateral groups showed no significant difference (P ＞ 0.05).Whether in high or low risk populations,the metastasis and recurrence between dissection group and non-dissection groups showed no significant difference (P ＞0.05).The temporary injury rate of recurrent laryngeal nerve in dissection group were higher than thatin non-dissection group both in high-risk populations (P =0.040,P ＜ 0.05) and low risk populations(P =0.037,P ＜ 0.05).Conclusions Intraoperative frozen pathological diagnosis of papillary thyroid microcarcinoma is difficult.The reasonable surgical approach for the first time is ipsilateral lobe plus isthmus resection.Preventive cervical dissections operation should not be carried out if the exploratory of lymph node showed no metastasis.
