Endoscopic lateral neck dissection via the breast and transoral approaches for papillary thyroid carcinoma: a report of 10 cases.
10.3760/cma.j.cn115330-20201015-00805
- VernacularTitle:经胸经口联合入路腔镜甲状腺癌颈侧区淋巴清扫手术10例临床分析
- Author:
Guo Yang WU
1
;
Jin Bo FU
1
;
Ye Zhe LUO
1
;
Wei YAN
1
;
Xiao Quan HONG
1
;
Peng Hao KUANG
1
;
En De LIN
1
;
Fu Sheng LIN
1
;
Zheng Fu SONG
1
;
Ji Yu CHEN
1
;
Yi Long FU
1
Author Information
1. Department of General Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361004, China.
- Publication Type:Journal Article
- MeSH:
Adult;
Female;
Humans;
Lymph Nodes;
Male;
Middle Aged;
Neck Dissection;
Retrospective Studies;
Thyroid Cancer, Papillary/surgery*;
Thyroid Neoplasms/surgery*;
Thyroidectomy;
Young Adult
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2021;56(7):751-754
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the feasibility of endoscopic lateral neck dissection via the breast and transoral approaches (ELNDBTOA) for papillary thyroid carcinoma (PTC). Methods: From February 2015 to April 2019, 10 patients with PTC (cN1b) including 1 male and 9 females aged from 22 to 53 years old received ELNDBTOA in the General Surgery Department of Zhongshan Hospital, Xiamen University. Total thyroidectomy, the central lymph node dissection and the selective neck dissection (levels Ⅱ, Ⅲ and Ⅳ) were performed endoscopically via the breast approach, and then the residual lymph nodes were dissected via transoral approach. The medical records, operation time, blood loss, complications and postoperative follow-up outcomes were analyzed retrospectively. SPSS 22.0 software package was used for statistical processing of clinical data of patients. Results: All cases were successfully treated with ELNDBTOA without transfer to open surgery. The average operative time was (362.5±79.7) min, the blood loss was (23.0±14.9) ml, and the postoperative hospital stay was (5.1±1.3) days. The mean number of harvested cervical lymph nodes were (34.2±25.8), and the mean number of positive lymph nodes were (6.5±4.9). Lymph nodes were dissected by the further dissection via oral approach in 6 patients and a total of 9 lateral lymph nodes were havested from 2 of the 6 patients, with 3 positive lymph nodes. Two patients had transient skin numbness in the mandibular area and recovered within two weeks. One patient developed transient hypoparathyroidism and recovered within two months. No secondary bleeding, recurrent laryngeal nerve paralysis, chylous leakage, neck infection, permanent hypoparathyroidism or other complications were observed. The follow-up time was from 16 to 66 months with a median of 42.5 months, no tumor recurrence or metastasis occurred, and also no obvious deformity, abnormal sensation or movement in the chest, neck and mouth was observed. Conclusions: ELNBTOA is safe and feasible, with good cosmetic outcome.
