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目的探讨术前临床颈部淋巴结阴性(c N0)期单病灶甲状腺微小乳头状癌(PTMC)预防性中央组淋巴结清扫的必要性、可行性、安全性及临床应用价值。方法回顾性分析2010-2015年连续收治的112例术前c N0期单病灶甲状腺微小乳头状癌患者的临床资料,112例患者均行患侧腺叶全切术,并预防性清扫同侧淋巴结,将同期因良性甲状腺疾病行单侧腺叶切除97例患者作为对照组,对比分析两组患者的临床资料。结果清扫组中央组淋巴结转移率10.71%(12/112)。两组患者均无永久性喉返神经及甲状旁腺功能受损。清扫组患者平均手术时间74 min(56-97 min)长于对照组65 min(45-81 min),差异有统计学意义。清扫组平均滞留引流管时间2.6 d(2-4 d),平均住院时间6.4 d(5-9 d);与对照组平均滞留引流管时间2.3 d(2-4 d)及平均住院天数5.9 d(4-8 d)相比,差异均无统计学意义。结论术前c N0期单病灶PTMC患者行预防性行中央组淋巴结清扫是必要且安全、可行。
Objective To investigate the necessity, feasibility, safety and clinical value of prophylactic central lymph node dissection in preoperative clinical cervical lymph node-negative (c N0) single-site thyroid papillary carcinoma (PTMC). Methods The clinical data of 112 patients with single thyroid papillary thyroid carcinoma preoperative c0N0 were retrospectively analyzed from 2010 to 2015. All 112 patients underwent resection of ipsilateral lobectomy and prophylactic ipsilateral lymph node dissection The same period 97 cases of benign thyroid disease underwent unilateral cystectomy as a control group, comparative analysis of two groups of patients with clinical data. Results The rate of lymph node metastasis in the central group was 10.71% (12/112). No permanent recurrent laryngeal nerve and parathyroid function were impaired in both groups. The average operation time of the patients in the cleaning group was longer than that of the control group (74 min, 56-97 min, 65 min, 45 min -81 min). The difference was statistically significant. The average dwell time of drainage tube was 2.6 d (2-4 d) and the average length of hospitalization was 6.4 d (5-9 d) in the cleaning group. The mean retention dredging tube time was 2.3 d (2-4 d) and the average length of hospital stay was 5.9 d (4-8 d), the differences were not statistically significant. Conclusion Preoperative c N0 single-site PTMC patients with central line lymph node dissection prevention is necessary and safe and feasible.