Clinical application of modified radical neck dissection by gasless unilateral axillary approach in papillary thyroid cancer
10.3760/cma.j.cn.115807-20220725-00200
- VernacularTitle:无充气经腋窝腔镜甲状腺乳头状癌侧颈部淋巴结清扫的临床应用
- Author:
Jiajie XU
1
;
Chuanming ZHENG
;
Yining ZHANG
;
Lingling DING
;
Haiwei GUO
;
Zhuo TAN
;
Jiafeng WANG
;
Liehao JIANG
;
Zhiqiang SUN
;
Ying XIN
;
Wanchen ZHANG
;
Chengying SHAO
;
Minghua GE
Author Information
1. 浙江省人民医院耳鼻咽喉-头颈外科中心，杭州医学院附属人民医院头颈外科，杭州 310014
- Keywords:
Endoscopic thyroid surgery;
Modified radical neck dissection;
Thyroid cancer;
Unilateral axillary approach
- From:
Chinese Journal of Endocrine Surgery
2023;17(1):5-10
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effectiveness, safety, and advantages of modified radical neck dissection by gasless unilateral axillary approach (GUA-MRND) in the surgical management of selected patients with papillary thyroid cancer.Methods:We retrospectively analyzed patients with papillary thyroid cancer who underwent GUA-MRND (endoscopic group, n=16) versus unilateral open modified radical neck dissection (MRND) (open group, n=32) during the period from Jan. 2019 to Jun. 2021, including the differences in surgical efficiency, complication rate, and incisional satisfaction.Results:Compared MRND with GUA-MRND, the patients were younger ( P<0.05) , operative time and postoperative drainage anterior ( P<0.01) were slightly inferior in the latter, but it had obvious advantages in cervical swallowing discomfort and incision satisfaction evaluation ( P<0.05) . There was no significant difference in the incidence of temporary recurrent laryngeal nerve injury, intraoperative and postoperative bleeding, hematoma, infection, lymphatic or chylous leakage and supraclavicular numbness after surgery ( P>0.05) . The number of dissected lymph nodes in area II in the GUA-MRND was lower ( P<0.05) , but it was significantly higher ( P<0.01) in area III. And the average regional cleaning efficiency in the GUA-MRND was level Ⅲ (35.5%) , level Ⅵ (28.59%) , level Ⅳ (23.21%) , level Ⅱ (7.18%) and level Ⅴ (7.12%) , suggested that GUA-MRND had higher efficacy for level III, level Ⅵ and Level IV. Conclusion:GUA-MRND is safe, effective, and has high cosmetic satisfaction in the treatment of selected patients with lateral cervical lymph node metastases from papillary thyroid cancer.
