Department of Thyroid and Breast Surgery, Yijishan Hospital, First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China.
Front Endocrinol (Lausanne). 2023 Jun 2;14:1131947. doi: 10.3389/fendo.2023.1131947. eCollection 2023.
To evaluate the value of refined extracapsular anatomy combined with carbon nanoparticle suspension tracing technology for protecting parathyroid function and the thoroughness of lymph node dissection in the central region during endoscopic thyroid cancer surgery.
Retrospective clinical data analysis was performed on 108 patients who underwent endoscopic thyroid cancer surgery at the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) from November 2019 to November 2022. Before surgery, thyroid function tests, color Doppler ultrasounds and neck-enhanced CT scans were performed on all patients. Cytopathological diagnosis obtained ultrasound-guided fine-needle aspiration served as confirmation for the primary diagnosis. It was determined whether to perform a total thyroidectomy or a hemithyroidectomy (HT) together with preventive unilateral (ipsilateral) central neck dissection. Follow-up times were 1 to 34 months.
Transient neuromuscular symptoms were present in 3.70% (4/108) cases, with no permanent neuromuscular symptoms or permanent hypoparathyroidism. Regarding transient hypoparathyroidism, the patients recovered after three months and did not need long-term calcium supplementation. The number of harvested LNs (mean± SD) was 5.54 ± 3.84, with ≤5 in 57.41% (62/108) and >5 in 42.59% (46/108) cases. The number of patients with metastatic LNs was 37.96% (41/108), with ≤2 in 65.85% (27/41) and >2 in 34.15% (14/41) cases.
Fine extracapsular anatomy combined with carbon nanoparticle suspension tracing is effective in endoscopic thyroid cancer surgery. It can improve the thoroughness of prophylactic central neck dissection and recognition of the parathyroid gland and avoid parathyroid injury and other complications to effectively protect parathyroid function.
评估精细化被膜解剖联合纳米碳混悬液示踪技术在保护甲状旁腺功能和内镜甲状腺癌手术中清扫中央区淋巴结彻底性方面的价值。
回顾性分析 2019 年 11 月至 2022 年 11 月皖南医学院第一附属医院（弋矶山医院）收治的 108 例行内镜甲状腺癌手术患者的临床资料。所有患者术前均行甲状腺功能检查、彩色多普勒超声及颈部增强 CT 扫描，超声引导下细针抽吸细胞学诊断为原发性诊断，确定行全甲状腺切除术或 HT 联合预防性单侧（对侧）中央区颈清扫术。随访时间为 1 至 34 个月。
暂时性神经肌肉症状发生率为 3.70%（4/108），无永久性神经肌肉症状或永久性甲状旁腺功能减退。暂时性甲状旁腺功能减退的患者在 3 个月后恢复，无需长期补钙。清扫的淋巴结数目（均数±标准差）为 5.54±3.84 个，其中 57.41%（62/108）的患者清扫的淋巴结数≤5 个，42.59%（46/108）的患者清扫的淋巴结数>5 个。转移淋巴结的患者占 37.96%（41/108），其中 65.85%（27/41）的患者转移淋巴结数≤2 个，34.15%（14/41）的患者转移淋巴结数>2 个。
精细化被膜解剖联合纳米碳混悬液示踪在经内镜甲状腺癌手术中是有效的，它可以提高预防性中央区颈清扫的彻底性和甲状旁腺的识别，避免甲状旁腺损伤等并发症，有效保护甲状旁腺功能。
