Objective: To generalize clinical application of a selected neck dissection through a low-collar incision in papillary thyroid carcinoma(PTC). Methods: We retrospectively analyzed clinical-pathology data of 160 PTC cases who underwent total thyroidectomy with a selected neck dissection through a low-collar incision and 42 PTC cases who underwent functional cervical dissection through L-form incision in our department from January, 2009 to September, 2014. Results: In 202 cases, metastatic rate of lymph node in neck central area was 71.3% while the lateral compartment was 54.5% and skipping metastasis was 5.94%. Smaller incision, shorter surgery time, minimal trauma,more cosmetic were the advantages of a selected neck dissection through a low-collar incision, but the results showed no differences in total hospitalization period, incidence of common complications, number of dissected lymph nodes and recurrence rate(P>0.05). The lateral compartment lymph nodes metastasis was related to sex,age,neck central area metastasis,capsular invasion,maximal diameter andmulifocalityin two groups(P<0.05). Conclusion: In thyroid carcinoma patients with clinically suspicious or radiographic suggested lateral cervical lymph node metastasis, especially for the cN0 patients who were male younger than 45 years old, larger or equal to 2.0 centimeter in max ultrasound diameter, neck central area metastasis, mulifocality or capsular invasion,it is suggested to take lateral compartment lymph nodes dissection. If the patients had no extensive cervical lymph node metastasis(level Ⅱ b and Ⅴ a) and invasion,a selective cervical node dissection through a low-collar incision is a safe and reasonable choice. |
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