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| Efficacy and Safety of Unilateral Lobectomy with Isthmectomy in the Treatment of T1/2cN0M0 Unilateral Multifocal Papillary Thyroid Carcinoma |
| YAN Shide, HU Kaibing, HU Gang, et al |
| The Second People's Hospital, Anhui Hefei 230032, China |
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Abstract Objective: To study the clinical efficacy and safety of unilateral lobectomy with isthmectomy in the treatment of T1/2cN0M0 unilateral multifocal papillary thyroid carcinoma (MPTC). Methods: Patients with T1/2cN0M0 unilateral MPTC who were admitted to the General Surgery Department, the Second People's Hospital of Hefei from January 2019 to December 2020 were selected as the research subjects. According to the inclusion and exclusion criteria, 51 patients who underwent total thyroidectomy combined with prophylactic bilateral VI lymph node dissection were selected as the control group. According to the gender, age±5, and tumor-node-metastasis (TNM) stage matching principle, 51 patients who underwent unilateral lobectomy combined with isthmectomy and prophylactic bilateral VI lymph node dissection in the hospital during the same period were selected as the observation group. The 2 groups were compared in terms of the operation time, intraoperative blood loss, length of the surgical incision, drainage volume, number of days of drainage tube removal, hospital stay, the incidence of postoperative complications, and postoperative progression-free survival (PFS). Results: The operation time, incision, intraoperative blood loss, postoperative drainage volume, number of days of drainage tube removal, and the hospital stay of the observation group were shorter/less than those of the control group (P<0.05). The incidence of postoperative complications in the observation group (11.76%) was significantly lower than that in the control group (49.02%) (P<0.05). No death or loss cases were found during follow-up. There were 2 cases of external cervical lymph node metastasis in the control group during the follow-up period, with an average survival time of 11 months and a PFS rate of 96.08%. There were 3 cases of recurrence and 2 cases of cervical lymph node metastasis in the observation group during the follow-up period, with an average survival time of 11 months and a PFS rate of 90.20%. The 2 groups had similar PFS (χ2=1.359, P=0.244). Conclusion: Unilateral lobectomy combined with isthmectomy is effective and safe in the treatment of T1/2cN0M0 unilateral MPTC, which can effectively reduce postoperative complications, thereby improving quality of life of the patients, and preventing recurrence.
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2023, Vol. 29 
