Efficacy of different surgical methods in the treatment of papillary thyroid carcinoma of the isthmus and their effects on parathyroid function and thyroglobulin
10.3760/cma.j.issn.1008-6706.2022.03.014
- VernacularTitle:不同手术方式治疗峡部甲状腺乳头状癌效果及对甲状旁腺功能和甲状腺球蛋白的影响
- Author:
Yun SUN
1
;
Xiaojin FU
;
Qian SA
Author Information
1. 浙江新安国际医院甲乳科，嘉兴 314000
- Keywords:
Thyroid neoplasms;
Papilloma;
Hypoparathyroidism;
Thyroglobulin;
Thyroidectomy;
Postoperative complications
- From:
Chinese Journal of Primary Medicine and Pharmacy
2022;29(3):383-386
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the therapeutic effects of different surgical methods on papillary thyroid carcinoma of the isthmus (PTCI) and their effects on parathyroid function and thyroglobulin.Methods:Eighty patients with PTCI who underwent treatment in Zhejiang Xin'an International Hospital from January 2016 to January 2021 were included in this study. They were randomly allocated to undergo ipsilateral lobectomy with removal of the isthmus combined with ipsilateral central neck lymph node dissection (group A, n = 40) or total thyroidectomy combined with ipsilateral central neck lymph node dissection (group B, n = 40). We compared intraoperative and postoperative conditions, complications, and hypoparathyroidism between the two groups. We also compared serum thyroglobulin level measured before and 3 days after surgery between the two groups. Results:Operative time was significantly shorter in group A than in group B [(78.95 ± 13.52) minutes vs. (104.23 ± 27.38) minutes, t = -5.23, P < 0.05]. Intraoperative blood loss was significantly less in group A than in group B [(52.32 ± 6.59) mL vs. (75.41 ± 9.98) mL, t = -12.21, P < 0.05]. There were no significant differences in voice handicap index and reflux symptom index scores between the two groups (both P > 0.05). The incidence of complications was significantly lower in group A than in group B (10.00% vs. 30.00%, χ2 = 5.00, P < 0.05). The incidence of hypoparathyroidism was significantly lower in group A than in group B (7.50% vs. 27.50%, χ2 = 5.54, P < 0.05). At 3 days after surgery, serum thyroglobulin level was significantly lower in group A than in group B [(0.82 ± 0.17) μg/L vs. (1.26 ± 0.23) μg/L, t = -9.73, P < 0.05]. Conclusion:Ipsilateral lobectomy with removal of the isthmus combined with ipsilateral central neck lymph node dissection is more effective on PTCI than total thyroidectomy combined with ipsilateral central neck lymph node dissection. The former has little effect on parathyroid function and can reduce serum thyroglobulin level. The study is highly innovative and scientific.
