Application of non inflatable endoscopic assisted lateral cervical lymph node dissection in elderly patients with thyroid cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

QIN Ruihao ¹ , MA Lina ² , XI Hailin ¹ , ZHAO Hao ¹ ,  FENG Su ¹

1. Department of Thyroid Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P. R. China;
2. Department of Thoracic Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P. R. China;

Corresponding?author：

FENG Su, Email: fengsumail@foxmail.com

Keywords：

thyroid cancer; non inflatable endoscopic surgery; lateral cervical lymph node dissection; elderly patient

DOI：

10.7507/1007-9424.202108107

Video：

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Objective To investigate the clinical effect of non inflatable endoscope assisted lateral cervical lymph node dissection in elderly patients with thyroid cancer. Methods The clinical data of 61 patients with lateral cervical lymphadenectomy assisted by non inflatable endoscope from January 2016 to December 2020 were retrospectively summarized. There were 48 females and 13 males with an average age of (71±6.5) years (range, 65–82 years). The operative time, intraoperative blood loss, cases of accessory nerve injury, cases of phrenic nerve injury, total number of lateral neck dissection lymph nodes, postoperative lymphatic leakage, postoperative drainage volume and hospital stay were counted. Neck ultrasonography and thyroglobulin levels were measured during follow-up to assess recurrence. Results All patients successfully completed the non inflatable endoscopic assisted lateral cervical lymph node dissection, the operative time was 51–117 min, the average was (92±22.1) min, the intraoperative blood loss was about 80–150 mL, the average was (120±17.1) mL, the postoperative drainage was 190–670 mL, the average was (332±167.1) mL, the postoperative hospital stay was 5–13 d, the average was (9±2.3) d, the total number of lymph nodes was 11–23, the average was (16±4.7). There were 11 cases of hypoparathyroidism, 5 cases of temporary recurrent laryngeal nerve injury, 3 cases of accessory nerve injury and no case of phrenic nerve injury. One patient had local redness and swelling after removing the drainage tube. Lymphatic leakage occurred in 3 cases. There was no recurrence during the follow-up period. Conclusion Non inflatable endoscope assisted lateral neck lymph node dissection provides technical support for elderly patients with thyroid cancer, and the effect is exact, and the short and medium-term follow-up results are satisfactory.

Citation： QIN Ruihao, MA Lina, XI Hailin, ZHAO Hao, FENG Su. Application of non inflatable endoscopic assisted lateral cervical lymph node dissection in elderly patients with thyroid cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(6): 779-782. doi: 10.7507/1007-9424.202108107 Copy

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2.	The L. Thyroid cancer screening. Lancet, 2017, 389(10083): 1954.
3.	王康偉, 王永, 張浩, 等. 腔鏡輔助改良Miccoli術式在甲狀腺癌頸側區淋巴結清掃中的應用體會. 腹腔鏡外科雜志, 2019, 24(6): 401-404.
4.	章德廣, 高力, 謝磊, 等. 改良Miccoli手術頸側區淋巴結清掃術治療甲狀腺乳頭狀癌130例臨床分析. 中華外科雜志, 2016, 54(11): 864-869.
5.	李婧, 馮蘇, 奚海林, 等. 改良胸前入路腔鏡甲狀腺手術與開放手術比較臨床分析. 中華普外科手術學雜志(電子版), 2015, 9(6): 50-52.
6.	賀紅杰. 頸淋巴結清掃手術在分化型甲狀腺癌手術中的應用價值. 臨床合理用藥雜志, 2019, 12(25): 114-115.
7.	郭方東, 王文瑞, 王平. 胸乳入路腔鏡頸側區淋巴結清掃術的療效分析. 腹腔鏡外科雜志, 2019, 24(12): 881-884.
8.	溫樹信, 馬培如, 張宇皓, 等. 頭頸腫瘤頸淋巴結清掃的手術選擇. 中華腫瘤雜志, 2021, 43(2): 176-179.
9.	馮蘇, 奚海林, 秦瑞浩, 等. 腔鏡下甲狀腺腺葉切除術治療甲狀腺微灶癌. 中華解剖與臨床雜志, 2018, 23(1): 71-75.
10.	宮毅, 左仲坤, 劉子儒, 等. 全乳暈入路腔鏡下甲狀腺微小乳頭狀癌手術的臨床經驗及療效. 中南大學學報(醫學版), 2019, 44(9): 1009-1015.
11.	賀青卿, 李小磊, 朱見. 雙側腋窩乳暈入路機器人甲狀腺癌切除的經驗與技巧. 外科理論與實踐, 2019, 24(6): 489-494.
12.	王野馳. 腔鏡輔助下多功能保留側頸淋巴結清掃術與傳統多功能保留側頸淋巴結清掃術治療甲狀腺乳頭狀癌的臨床療效比較分析. 吉林大學, 2020.
13.	張俊偉. 腔鏡輔助小切口患側甲狀腺腺葉切除聯合Ⅵ區頸淋巴結清掃術治療甲狀腺微小乳頭狀癌臨床效果觀察. 河南外科學雜志, 2021, 27(2): 63-65.
14.	Rulli F, Galata G, Pompeo E, et al. A camera handler for Miccoli’s minimally invasive video-assisted thyroidectomy and paratiroidectomy procedures. Surg Endosc, 2007, 21(6): 1017-1019.
15.	陳明, 張麗. 改良Miccoli手術與傳統甲狀腺手術治療甲狀腺良性疾病的效果比較. 中國醫藥指南, 2018, 16(33): 1-2.
16.	由法平, 孫愛輝, 卜慶敖, 等. 改良Miccoli手術在全甲狀腺切除術中對甲狀旁腺保護研究. 中華腫瘤防治雜志, 2017, 24(13): 912-915.
17.	李旭, 羅文浩, 厲周. 腔鏡甲狀腺癌手術的進展與爭議. 腫瘤防治研究, 2018, 45(6): 429-432.
18.	Shen X, Miao ZM, Lu W, et al. Clinical experience with modified Miccoli’s endoscopic thyroidectomy for treatment of thyroid carcinoma in 86 cases. Eur J Med Res, 2013, 18: 51. doi: 10.1186/2047-783X-18-51.
19.	劉利, 任澤強, 張蓬波, 等. 腔鏡輔助下甲狀腺乳頭狀癌根治術的臨床效果分析. 中華普外科手術學雜志(電子版), 2017, 11(04): 345-347.
20.	Terris DJ, Seybt MW. Modifications of Miccoli minimally invasive thyroidectomy for the low-volume surgeon. Am J Otolaryngol, 2011, 32(5): 392-397.
21.	徐林, 劉樂陽, 尹劍輝, 等. 對比、分析用改良的Miccoli手術與傳統甲狀腺手術治療甲狀腺良性疾病的臨床效果. 中國社區醫師, 2018, 34(16): 75,77.
22.	Yu H, Ge X, Pan W, et al. Modified Miccoli’s thyroid surgery for thyroid diseases. Mol Clin Oncol, 2015, 3(5): 1014-1018.

1. Wang TS, Sosa JA. Thyroid surgery for differentiated thyroid cancer—recent advances and future directions. Nat Rev Endocrinol, 2018, 14(11): 670-683.
2. The L. Thyroid cancer screening. Lancet, 2017, 389(10083): 1954.
3. 王康偉, 王永, 張浩, 等. 腔鏡輔助改良Miccoli術式在甲狀腺癌頸側區淋巴結清掃中的應用體會. 腹腔鏡外科雜志, 2019, 24(6): 401-404.
4. 章德廣, 高力, 謝磊, 等. 改良Miccoli手術頸側區淋巴結清掃術治療甲狀腺乳頭狀癌130例臨床分析. 中華外科雜志, 2016, 54(11): 864-869.
5. 李婧, 馮蘇, 奚海林, 等. 改良胸前入路腔鏡甲狀腺手術與開放手術比較臨床分析. 中華普外科手術學雜志(電子版), 2015, 9(6): 50-52.
6. 賀紅杰. 頸淋巴結清掃手術在分化型甲狀腺癌手術中的應用價值. 臨床合理用藥雜志, 2019, 12(25): 114-115.
7. 郭方東, 王文瑞, 王平. 胸乳入路腔鏡頸側區淋巴結清掃術的療效分析. 腹腔鏡外科雜志, 2019, 24(12): 881-884.
8. 溫樹信, 馬培如, 張宇皓, 等. 頭頸腫瘤頸淋巴結清掃的手術選擇. 中華腫瘤雜志, 2021, 43(2): 176-179.
9. 馮蘇, 奚海林, 秦瑞浩, 等. 腔鏡下甲狀腺腺葉切除術治療甲狀腺微灶癌. 中華解剖與臨床雜志, 2018, 23(1): 71-75.
10. 宮毅, 左仲坤, 劉子儒, 等. 全乳暈入路腔鏡下甲狀腺微小乳頭狀癌手術的臨床經驗及療效. 中南大學學報(醫學版), 2019, 44(9): 1009-1015.
11. 賀青卿, 李小磊, 朱見. 雙側腋窩乳暈入路機器人甲狀腺癌切除的經驗與技巧. 外科理論與實踐, 2019, 24(6): 489-494.
12. 王野馳. 腔鏡輔助下多功能保留側頸淋巴結清掃術與傳統多功能保留側頸淋巴結清掃術治療甲狀腺乳頭狀癌的臨床療效比較分析. 吉林大學, 2020.
13. 張俊偉. 腔鏡輔助小切口患側甲狀腺腺葉切除聯合Ⅵ區頸淋巴結清掃術治療甲狀腺微小乳頭狀癌臨床效果觀察. 河南外科學雜志, 2021, 27(2): 63-65.
14. Rulli F, Galata G, Pompeo E, et al. A camera handler for Miccoli’s minimally invasive video-assisted thyroidectomy and paratiroidectomy procedures. Surg Endosc, 2007, 21(6): 1017-1019.
15. 陳明, 張麗. 改良Miccoli手術與傳統甲狀腺手術治療甲狀腺良性疾病的效果比較. 中國醫藥指南, 2018, 16(33): 1-2.
16. 由法平, 孫愛輝, 卜慶敖, 等. 改良Miccoli手術在全甲狀腺切除術中對甲狀旁腺保護研究. 中華腫瘤防治雜志, 2017, 24(13): 912-915.
17. 李旭, 羅文浩, 厲周. 腔鏡甲狀腺癌手術的進展與爭議. 腫瘤防治研究, 2018, 45(6): 429-432.
18. Shen X, Miao ZM, Lu W, et al. Clinical experience with modified Miccoli’s endoscopic thyroidectomy for treatment of thyroid carcinoma in 86 cases. Eur J Med Res, 2013, 18: 51. doi: 10.1186/2047-783X-18-51.
19. 劉利, 任澤強, 張蓬波, 等. 腔鏡輔助下甲狀腺乳頭狀癌根治術的臨床效果分析. 中華普外科手術學雜志(電子版), 2017, 11(04): 345-347.
20. Terris DJ, Seybt MW. Modifications of Miccoli minimally invasive thyroidectomy for the low-volume surgeon. Am J Otolaryngol, 2011, 32(5): 392-397.
21. 徐林, 劉樂陽, 尹劍輝, 等. 對比、分析用改良的Miccoli手術與傳統甲狀腺手術治療甲狀腺良性疾病的臨床效果. 中國社區醫師, 2018, 34(16): 75,77.
22. Yu H, Ge X, Pan W, et al. Modified Miccoli’s thyroid surgery for thyroid diseases. Mol Clin Oncol, 2015, 3(5): 1014-1018.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of non inflatable endoscopic assisted lateral cervical lymph node dissection in elderly patients with thyroid cancer

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