Ding B, Yu J-F, Sun W, Ma N-F
The Third General Surgery, The Central Hospital of Zhumadian City, Zhumadian City, China.
Eur Rev Med Pharmacol Sci. 2017 Jan;21(2):234-238.
The objective of the present study was to analyze the surgical safety of retaining the glands in papillary thyroid microcarcinoma (mPTC).
156 cases of mPTC were retrospectively reviewed and divided into four groups according to the treatment: group A (conservative follow-up group, 30 cases), group B (total resection of unilateral gland combined with isthmic resection, 48 cases), group C (total resection of unilateral gland combined with subtotal resection of contralateral gland, 47 cases), and group D (total resection of bilateral glands, 31 cases). The average follow-up time was 34.5 months.
The occurrence rate of hypothyroidism, hypoparathyroidism, hypocalcemia, injury of the recurrent laryngeal nerve and total occurrence rate in the group B were significantly lower than in the group C and group D, and the differences were statistically significant (p<0.05). The 75% survival time was 33 months in group A, 35 months in group B, and 34 months in group D. The survival time of group A was significantly less than in the other groups, and the difference was statistically significant (p<0.001). There was no significant difference in the comparison of total mortality rate and recurrence rate (p>0.05).
The total resection of the unilateral gland combined with isthmic resection, which conserves gland functionality, reduces complications and maintains survival time. It is, therefore, worthy of further clinical application.
本研究的目的是分析在甲状腺微小乳头状癌（mPTC）中保留腺体的手术安全性。
回顾性分析156例mPTC患者，并根据治疗方法分为四组：A组（保守随访组，30例）、B组（单侧腺叶全切除加峡部切除，48例）、C组（单侧腺叶全切除加对侧腺叶次全切除，47例）和D组（双侧腺叶全切除，31例）。平均随访时间为34.5个月。
B组甲状腺功能减退、甲状旁腺功能减退、低钙血症、喉返神经损伤的发生率及总发生率均显著低于C组和D组，差异有统计学意义（p<0.05）。A组的75%生存时间为33个月，B组为35个月，D组为34个月。A组的生存时间显著短于其他组，差异有统计学意义（p<0.001）。总死亡率和复发率比较差异无统计学意义（p>0.05）。
单侧腺叶全切除加峡部切除可保留腺体功能，减少并发症并维持生存时间，因此值得进一步临床应用。
