中央组淋巴结清扫术在cN0甲状腺乳头状微小癌手术中的应用

目的探讨临床颈侧淋巴结阴性（cN0）的甲状腺乳头状微小癌（PTMC）患者行中央组淋巴结清扫术的疗效。方法回顾分析35例cN0的PTMC患者行中央组淋巴结清扫的临床资料，双侧PTMC3例行甲状腺腺叶全切除术，32例单侧PTMC均行患侧甲状腺腺叶、峡部甲状腺全切及对侧甲状腺腺叶次全切除术，所有病例均行中央组淋巴结清扫术。结果4例有中央组淋巴结转移，再行改良颈清淋巴结均未及转移；其余31例中央组淋巴结未及转移。1例术后发生左颈部淋巴漏，13例术后出现一过性甲状旁腺功能低下，补钙后缓解，2周后恢复正常；2例喉返神经麻痹。经6～42个月的随访，35例患者均未发现颈部淋巴结转移。结论对cN0的PTMC患者常规行中央组淋巴结清扫有助于改善其生存情况，可以通过提高手术技巧降低手术的并发症发生率。

Clinical application of central compartment neck dissection for cNO papillary thyroid microcarcinoma

Objective To evaluate the effect of the central compartment neck dissection for cNO papillary thyroid mierocarcinoma(PTMC). Methods In 35 cases with oN0 PTMC, total thyroidectomy was performed on 3 bilateral PTMC cases, homolateral lobe and isthmus total thyroidectomy + contralateral lobe near total thyroidectomy was performed on 32 unilateral PTMC cases. The central compartment lymph node dissection was performed on all cases. Results Homolateral functional neck dissection was performed on 4 cases with positive nodes and the specimens were sent for routine histopathological examination which were not found metastasis. There were no such metastasis on the remaining 31 cases. 1 patient was complicated with lymph leakage. 2 patients was complicated with recurrent laryngeal nerve paralysis. 13 patients was complicated with transient postoperative hypoparathyroidism, which returned to normal 2 weeks later with the help of added calcium. 35 patients were followed - up from 6 to 42 months. All the cases were not found metastasis. Conclusions Routine central compartment neck dissection may be helpful to improve the survival of cN0 PTMC patients. Meanwhile, complication could be decreased by improving surgical skills.