1.A study on the metastasis related location of superior mediastinal lymph nodes in thyroid cancer
Deguang ZHANG ; Hu ZHANG ; Gaofei HE ; Xiaoxiao LU ; Li GAO ; Jian CHEN ; Liang FANG ; Jianbo LI ; Chongwu JIN
Chinese Journal of General Surgery 2021;36(6):426-431
Objective:To explore superior mediastinal lymph node zoning of thyroid cancer for accurate anatomical definition as a reference for surgical access. Methods:A method for zoning superior mediastinal lymph nodes for thyroid cancer was proposed. From Sep 2018 to Nov 2019, 36 cases of thyroid cancer with superior mediastinal lymph nodes metastases were reviewed. The diagnosis, surgical approaches, pathology, characteristics of lymph node metastasis, complications and follow-up results were analyzed.Results:The superior mediastinal lymph nodes were grouped into 10 areas: 1, 2Ra, 2Rb, 2La, 2Lb, 3A, 3P, 4R, 4La and 4Lb. According to the location of the superior mediastinum metastatic lymph nodes, direct vision approach through the neck incision, laparoscope-assisted approach, thracoscepy, laparoscope-assisted combined with thrascopy approach or conventional median sternotomy was performed for regional lymph node dissection. The average follow-up time was (10±4) months. No residual or recurrence of tumor in superior mediastinal area was found.Conclusions:The zoning of the superior mediastinal lymph nodes in thyroid cancer can be used as a guide for surgical approach to lymph node dissection .
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