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Ⅵ区淋巴结是甲状腺乳头状癌最常见的转移部位,对cN1病人行Ⅵ区淋巴结清扫已没有异议,但对cN0病人是否常规行Ⅵ区淋巴结清扫还存在一定的争议,而现有资料表明常规进行Ⅵ区淋巴结清扫术对cN0甲状腺乳头状癌病人具有重要的临床意义。常规进行Ⅵ区淋巴结清扫术有利于彻底切除隐匿性的转移淋巴结、减少肿瘤复发和改善存活率,降低颈侧方的淋巴结转移发生率,有利于肿瘤的准确临床分期,对制定术后综合治疗和随访方案、评估术后复发危险性以及判断预后有重要价值,同时能够避免再次手术时损伤喉返神经,降低手术并发症发生率。因此,我们提倡对cN0甲状腺乳头状癌病人在根治原发灶的基础上常规进行Ⅵ区淋巴结清扫术,对解剖结构的熟悉和手术技巧的熟练是预防该手术并发症的关键。
Ⅵ regional lymph nodes is the most common thyroid papillary thyroid metastasis of the cN1 patients line Ⅵ area lymph node dissection has no objection, but cN0 patients routine Ⅵ area lymph node dissection there is still some controversy, and the existing data indicate that conventional Ⅵ regional lymphadenectomy for cN0 thyroid papillary carcinoma patients has an important clinical significance. Routine Ⅵ regional lymph node dissection is conducive to the complete removal of occult metastatic lymph nodes, reduce tumor recurrence and improve survival rate, reduce the incidence of cervical lymph node metastasis, is conducive to the accurate clinical stage of the tumor, to develop postoperative comprehensive treatment and Follow-up program to assess the risk of postoperative recurrence and the prognosis of prognostic value, while avoiding the re-operation of the injured laryngeal nerve, reducing the incidence of surgical complications. Therefore, we advocate routine cystectomy lymph node dissection in patients with cN0 thyroid papillary carcinoma on the basis of radical primary tumor, familiar with anatomical structure and skill of surgery is the key to prevent the complications of surgery.