Surgical safety analysis of retained glands for micro-papillary thyroid carcinoma

Abstract

Objective To study the surgical safety of retained glands for micro-papillary thyroid carcinoma(mPTC). Methods A total of two hundred patients with mPTC from June 2012 to June 2016 in Seventh People's Hospital of Shanghai University of TCM were enrolled in this study: single follow-up group(group A, 40 cases), unilateral total lobectomy+ isthmus resection group(group B, 85 cases), unilateral total lobectomy+ contralateral lobe subtotal resection group(group C, 45 cases), bilateral total lobectomy (group D, 30 cases), then the clinical outcome was compared. Results The average follow-up time was about 26.5 months, and there was no significant increase in tumor diameter in group A ( (6.6±1.5) mm vs.(6.5±1.3) mm, t=0.326, P=0.621). The incidences of hypothyroidism in group B and C were significantly lower than that in group D(7.1% vs.30.0%, χ2=8.366, P=0.004, 11.1% vs.30.0%, χ2=4.230, P=0.040), while the differences in hypoparathyroidism, hypocalcemia, laryngeal nerve injury and total rate among group B, C and D were not statistically significant(P>0.05). The median survival times in group B, C and D were significantly longer than that in group A (42.2months, 43.5months, 43.6months vs.32.8months, P 0.05). There was no statistically significant difference in 3-year tumor mortality and recurrence rates among the three groups (P>0.05). Conclusion Unilateral lobe resection + isthmus resection + ipsilateral central lymph node dissection can maintain the gland function, reduce complications, without reducing the survival, it is worthy of popularization and application. Key words: Micro-papillary thyroid carcinoma; Unilateral total lobectomy; Complications