Wang Bin, Zhu Chun-Rong, Fei Yuan, ShanZhou Qiyue, Liu Hong, Yao Xin-Min, Wu Jian
Center of Breast and Thyroid Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.
Department of Oncology Ward 2, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.
Front Endocrinol (Lausanne). 2024 Dec 23;15:1461553. doi: 10.3389/fendo.2024.1461553. eCollection 2024.
This study aimed to assess the degree of effect of central lymph node dissection on postoperative hypoparathyroidism incidence.
The incidence of postoperative hypoparathyroidism was compared between patients receiving thyroidectomy with central neck dissection for papillary thyroid carcinoma and those undergoing thyroidectomy for benign thyroid diseases (thyroid follicular adenoma and/or nodular goiter) necessitating surgical intervention.
The incidence of postoperative hypoparathyroidism was not significantly different between the groups of lobe thyroidectomy for benign thyroid diseases and lobe thyroidectomy with ipsilateral central lymph node dissection for papillary thyroid carcinoma (immediate: 9.2% vs 3.0%, P = 0.157; protracted: 4.6% vs 0%, P = 0.06; permanent: 0% vs 0%). Similarly, there was no significant difference in the postoperative hypoparathyroidism incidence between total thyroidectomy for benign thyroid diseases and total thyroidectomy with ipsilateral central lymph node dissection for papillary thyroid carcinoma (immediate: 25.0% vs 33.8%, P = 0.12; protracted: 4.5% vs 5.3%, P = 0.99; permanent: 1.1% vs 0.9%, P > 0.99).
While the rates of postoperative hypoparathyroidism during thyroid surgery with ipsilateral central lymph node dissection may be slightly elevated compared to surgery without it for papillary thyroid carcinoma, they remained akin to those observed during surgery for benign thyroid diseases that need surgical management.
本研究旨在评估中央淋巴结清扫对术后甲状旁腺功能减退症发生率的影响程度。
比较接受甲状腺癌乳头状癌中央区清扫的甲状腺切除术患者与因良性甲状腺疾病(甲状腺滤泡性腺瘤和/或结节性甲状腺肿)需要手术干预而接受甲状腺切除术的患者术后甲状旁腺功能减退症的发生率。
良性甲状腺疾病的叶甲状腺切除术组与甲状腺癌乳头状癌同侧中央淋巴结清扫的叶甲状腺切除术组之间,术后甲状旁腺功能减退症的发生率无显著差异(即刻:9.2%对3.0%,P = 0.157;迁延性:4.6%对0%,P = 0.06;永久性:0%对0%)。同样,良性甲状腺疾病的全甲状腺切除术组与甲状腺癌乳头状癌同侧中央淋巴结清扫的全甲状腺切除术组之间,术后甲状旁腺功能减退症的发生率也无显著差异(即刻:25.0%对33.8%,P = 0.12;迁延性:4.5%对5.3%,P = 0.99;永久性:1.1%对0.9%,P > 0.99)。
虽然与未进行同侧中央淋巴结清扫的甲状腺癌手术相比,进行同侧中央淋巴结清扫的甲状腺手术术后甲状旁腺功能减退症的发生率可能略有升高,但仍与需要手术治疗的良性甲状腺疾病手术中的发生率相近。