The Clinical Annlysis For Bilateral Neck Dissection Synchronously In 112 Patients Of Thyroid Carcinoma

Objective To explorer the indications and notes of one stage thyroidectomy and bilateral neck dissection for thyroid carcinoma.Methods The clinical and pathological data of 112 thyroid carcinoma patients treated with one stage thyroidectomy and bilateral neck dissection from Jan 1990 to Dec 2006 were reviewed retrospectively.Results There was no operative death in this group. Of the 112 patients: 86 had bilateral positive lymph nodes; 19 unilateral positive; 7 negative lymph nodes. The patients who had bilateral thyroid cancer with unilateral cervical lymph nodes, who had isthmus cancer with unilateral cervical lymph nodes and who had unilateral thyroid cancer with contralateral neck lymph nodes,were 75.8%(47/62),70.6%(12/17),81.8%(27/33)histologically detected bilateral lymph node metastasis respectively (P>0.05). Postoperative complications included:8 facial and flap edema,3 headache,6 postoperative hoarseness,7 temporality hypoparathyroidism,1 permanent hypoparathyroidism,1 left chylus fistula,3 unilateral accessory nerve injury.Conclusion The patients who had bilateral thyroid cancer with unilateral cervical lymph nodes,who had isthmus cancer with unilateral cervical lymph nodes and who had unilateral thyroid cancer with contralateral neck lymph nodes, were in high-risk group of bilateral neck metastasis, who should be treated with one stage thyroidectomy and bilateral neck lymph node dissection. The procedure is safe and no serious postoperative complications were observed, the patients, survival and quality of life can be improved.