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

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.	王康伟, 王永, 张浩, 等. 腔镜辅助改良Miccoli术式在甲状腺癌颈侧区淋巴结清扫中的应用体会. 腹腔镜外科杂志, 2019, 24(6): 401-404.
4.	章德广, 高力, 谢磊, 等. 改良Miccoli手术颈侧区淋巴结清扫术治疗甲状腺乳头状癌130例临床分析. 中华外科杂志, 2016, 54(11): 864-869.
5.	李婧, 冯苏, 奚海林, 等. 改良胸前入路腔镜甲状腺手术与开放手术比较临床分析. 中华普外科手术学杂志(电子版), 2015, 9(6): 50-52.
6.	贺红杰. 颈淋巴结清扫手术在分化型甲状腺癌手术中的应用价值. 临床合理用药杂志, 2019, 12(25): 114-115.
7.	郭方东, 王文瑞, 王平. 胸乳入路腔镜颈侧区淋巴结清扫术的疗效分析. 腹腔镜外科杂志, 2019, 24(12): 881-884.
8.	温树信, 马培如, 张宇皓, 等. 头颈肿瘤颈淋巴结清扫的手术选择. 中华肿瘤杂志, 2021, 43(2): 176-179.
9.	冯苏, 奚海林, 秦瑞浩, 等. 腔镜下甲状腺腺叶切除术治疗甲状腺微灶癌. 中华解剖与临床杂志, 2018, 23(1): 71-75.
10.	宫毅, 左仲坤, 刘子儒, 等. 全乳晕入路腔镜下甲状腺微小乳头状癌手术的临床经验及疗效. 中南大学学报(医学版), 2019, 44(9): 1009-1015.
11.	贺青卿, 李小磊, 朱见. 双侧腋窝乳晕入路机器人甲状腺癌切除的经验与技巧. 外科理论与实践, 2019, 24(6): 489-494.
12.	王野驰. 腔镜辅助下多功能保留侧颈淋巴结清扫术与传统多功能保留侧颈淋巴结清扫术治疗甲状腺乳头状癌的临床疗效比较分析. 吉林大学, 2020.
13.	张俊伟. 腔镜辅助小切口患侧甲状腺腺叶切除联合Ⅵ区颈淋巴结清扫术治疗甲状腺微小乳头状癌临床效果观察. 河南外科学杂志, 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.	陈明, 张丽. 改良Miccoli手术与传统甲状腺手术治疗甲状腺良性疾病的效果比较. 中国医药指南, 2018, 16(33): 1-2.
16.	由法平, 孙爱辉, 卜庆敖, 等. 改良Miccoli手术在全甲状腺切除术中对甲状旁腺保护研究. 中华肿瘤防治杂志, 2017, 24(13): 912-915.
17.	李旭, 罗文浩, 厉周. 腔镜甲状腺癌手术的进展与争议. 肿瘤防治研究, 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.	刘利, 任泽强, 张蓬波, 等. 腔镜辅助下甲状腺乳头状癌根治术的临床效果分析. 中华普外科手术学杂志(电子版), 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, 刘乐阳, 尹剑辉, 等. 对比、分析用改良的Miccoli手术与传统甲状腺手术治疗甲状腺良性疾病的临床效果. 中国社区医师, 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. 王康伟, 王永, 张浩, 等. 腔镜辅助改良Miccoli术式在甲状腺癌颈侧区淋巴结清扫中的应用体会. 腹腔镜外科杂志, 2019, 24(6): 401-404.
4. 章德广, 高力, 谢磊, 等. 改良Miccoli手术颈侧区淋巴结清扫术治疗甲状腺乳头状癌130例临床分析. 中华外科杂志, 2016, 54(11): 864-869.
5. 李婧, 冯苏, 奚海林, 等. 改良胸前入路腔镜甲状腺手术与开放手术比较临床分析. 中华普外科手术学杂志(电子版), 2015, 9(6): 50-52.
6. 贺红杰. 颈淋巴结清扫手术在分化型甲状腺癌手术中的应用价值. 临床合理用药杂志, 2019, 12(25): 114-115.
7. 郭方东, 王文瑞, 王平. 胸乳入路腔镜颈侧区淋巴结清扫术的疗效分析. 腹腔镜外科杂志, 2019, 24(12): 881-884.
8. 温树信, 马培如, 张宇皓, 等. 头颈肿瘤颈淋巴结清扫的手术选择. 中华肿瘤杂志, 2021, 43(2): 176-179.
9. 冯苏, 奚海林, 秦瑞浩, 等. 腔镜下甲状腺腺叶切除术治疗甲状腺微灶癌. 中华解剖与临床杂志, 2018, 23(1): 71-75.
10. 宫毅, 左仲坤, 刘子儒, 等. 全乳晕入路腔镜下甲状腺微小乳头状癌手术的临床经验及疗效. 中南大学学报(医学版), 2019, 44(9): 1009-1015.
11. 贺青卿, 李小磊, 朱见. 双侧腋窝乳晕入路机器人甲状腺癌切除的经验与技巧. 外科理论与实践, 2019, 24(6): 489-494.
12. 王野驰. 腔镜辅助下多功能保留侧颈淋巴结清扫术与传统多功能保留侧颈淋巴结清扫术治疗甲状腺乳头状癌的临床疗效比较分析. 吉林大学, 2020.
13. 张俊伟. 腔镜辅助小切口患侧甲状腺腺叶切除联合Ⅵ区颈淋巴结清扫术治疗甲状腺微小乳头状癌临床效果观察. 河南外科学杂志, 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. 陈明, 张丽. 改良Miccoli手术与传统甲状腺手术治疗甲状腺良性疾病的效果比较. 中国医药指南, 2018, 16(33): 1-2.
16. 由法平, 孙爱辉, 卜庆敖, 等. 改良Miccoli手术在全甲状腺切除术中对甲状旁腺保护研究. 中华肿瘤防治杂志, 2017, 24(13): 912-915.
17. 李旭, 罗文浩, 厉周. 腔镜甲状腺癌手术的进展与争议. 肿瘤防治研究, 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. 刘利, 任泽强, 张蓬波, 等. 腔镜辅助下甲状腺乳头状癌根治术的临床效果分析. 中华普外科手术学杂志(电子版), 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, 刘乐阳, 尹剑辉, 等. 对比、分析用改良的Miccoli手术与传统甲状腺手术治疗甲状腺良性疾病的临床效果. 中国社区医师, 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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