Clinical application of the six-step suspension method in endoscopic lateral neck dissection via the chest-breast approach for the treatment of papillary thyroid carcinoma
10.3760/cma.j.cn112139-20241101-00485
- VernacularTitle:六步悬吊法胸乳入路腔镜颈侧区淋巴结清扫术治疗甲状腺乳头状癌的临床应用
- Author:
Nan XU
1
;
Ziyu LI
;
Lina FU
;
Xunpeng LUO
;
Shikuo RONG
;
Junqing LIN
;
Yuanyang WANG
;
Xinjie LIU
;
Bo XU
Author Information
1. 深圳市人民医院（南方科技大学第一附属医院 暨南大学第二临床医学院）甲状腺外科，深圳 518020
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Surgical procedures, operative;
Papillary thyroid carcinoma;
Lateral neck dissection;
Endoscopic;
Chest-breast approach;
Suspension metho
- From:
Chinese Journal of Surgery
2025;63(6):535-540
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility of a six-step suspension technique for endoscopic lateral neck dissection (LND) through the chest-breast approach in patients with papillary thyroid carcinoma (PTC).Methods:This is a retrospective case series study.Clinical data of 81 PTC patients who underwent endoscopic LND via the chest-breast approach using the six-step suspension method at the Department of Thyroid Surgery, Shenzhen People′s Hospital were collected from January 2022 to October 2024. The cohort consisted of 15 male and 66 female patients, with age of (35.2±10.2)years (range:8.5 to 65.0 years). Key variables, including LND duration, total operative time, postoperative hospital stay, details of lymph node metastasis, postoperative complications, and follow-up data were recorded and analyzed.Results:The duration of LND was (131.8±42.2)minutes (range: 65 to 275 minutes), and the total operative time was (195.5±49.6)minutes (range: 110 to 390 minutes). The postoperative hospital stay was (4.8±1.5)days(range:3 to 15 days). The number of dissected lateral cervical lymph nodes was 32.7±10.1 (range: 11 to 54). The maximum tumor diameter was (16.1±10.1)mm(range:2 to 30 mm), while the maximum size of metastatic lymph nodes was (16.7±6.2)mm(range:7 to 30 mm). The positivity rate was 24.7% (841/3 410) in the lateral cervical+central lymph node and 16.1% (427/2 646) in the lateral cervical lymph node. Postoperative lymphatic leakage occurred in 2 patients, both of whom were successfully treated conservatively. No other significant complications were reported. During the postoperative follow-up period, which lasted for (18.3±7.4) months (range: 1.1 to 34.4 months), the mean postoperative serum thyroglobulin (Tg) level ( M(IQR)) was 0.05 (0.50) μg/L (range: 0.01 to 7.90 μg/L), with 86.4% of patients showing a Tg ≤1.00 μg/L. Through imaging evaluations, no evidence of residual disease or recurrence was detected. Conclusion:Endoscopic LND via the chest-breast approach, utilizing the six-step suspension method, maybe a feasible and effective technique with promising clinical outcomes.
