Clinical analysis of total thyroidectomy plus prophylactic central lymph node dissection in the treatment of patients with multifocal papillary thyroid carcinoma
10.3760/cma.j.issn.1008-6706.2017.13.029
- VernacularTitle:全甲状腺切除联合预防性中央区淋巴结清扫术治疗多灶性甲状腺乳头状癌临床分析
- Author:
Tao ZHU
- Keywords:
Thyroid neoplasms;
Thyroidectomy;
Lymph node excision;
Lymphatic metastasis
- From:
Chinese Journal of Primary Medicine and Pharmacy
2017;24(13):2034-2037
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical effect of total thyroidectomy plus prophylactic central lymph node dissection in the treatment of multifocal papillary thyroid carcinoma.Methods Using EXCEL random number method according to the proportion of 1︰1,87 patients with multifocal papillary thyroid carcinoma were divided into treatment group(n=44) and control group(n=43).The control group was treated by ipsilateral lobectomy and isthmus resection and ipsilateral central lymph node dissection,the treatment group was treated by total thyroidectomy plus prophylactic central lymph node dissection.The tumor size,lymph node involvement,the score of SF-36,the complications and the rate of postoperative recurrence,metastasis and mortality of the two groups were compared.Results The tumor size,lymph node involvement and complications in the treatment group had no statistically significant differences compared with the control group(χ2=1.194,P=0.610;χ2=0.680,P=0.500,χ2=0.603,P=0.438).After treatment,the SF-36 scores of the two groups were significantly higher than before treatment(t=7.927,P=0.000;t=5.374,P=0.000).The SF-36 score of the treatment group was (76.47±13.72)points,which was significantly higher than (68.88±15.36)points of the control group(t=2.429,P=0.017).The patients were followed up for 6 months,there was no recurrence in the treatment group,while there were 5 cases in the control group,the difference was statistically significant(χ2=5.428,P=0.026).There was no metastasis in the treatment group,while there were 6 cases in the control group,the difference was statistically significant(χ2=6.594,P=0.012).Conclusion Total thyroidectomy plus prophylactic central lymph node dissection in the treatment of multifocal papillary thyroid carcinoma has significant clinical curative effect.It can effectively reduce the risk of tumor recurrence and metastasis and improve the quality of life of patients.It is worthy of popularization and application.
