| Objective:Sternocleidomastoid lateral path and traditional surgical procedure in differentiated thyroid cancer lateral neck lymph node cleaning scope of success rate,operation time,hospitalization time,incision length,intraoperative blood loss,postoperative flow,postoperative drainage time and the degree of postoperative incision,postoperative complications and postoperative local recurrence of application value.Methods:Retrospective study,the selection in our department between September 2014 and September 2016 accepts to hospital during the period of patients with preoperative ultrasound line or preoperative FNAB diagnosis suggest thyroid carcinoma with lateral neck lymph node enlargement and intraoperative rapid pathological reports 40 cases of patients with differentiated thyroid cancer is determined,each 20 cases were randomly divided into control group and experimental group,20 patients with thyroid carcinoma were detected in thyroid cancer radical prostatectomy and lateral neck lymph node cleaning intraoperative use sternocleidomastoid lateral path(experimental group)and 20 cases of patients with thyroid cancer and lateral neck lymph node cleaning in thyroid cancer radical surgery with traditional operation method(control group)in lateral neck lymph node cleaning scope of success rate,operation time,hospitalization time,incision length,intraoperative blood loss,postoperative total flow rate,postoperative drainage time and the degree of postoperative incision,postoperative complications and the incidence of postoperative local recurrence,etc.Results :(1)Experimental group in the operation of the lymph node zone II,III,IV,V number respectively(2.35±1.07),(3.32±1.25),(3.04±1.95),(2.11±1.74).The control group in the operation of the lymph node zone II,III,IV,V number(2.49±1.37),respectively(3.67±1.04),(3.12±1.87),(2.09±1.97).Experimental group for differentiated thyroid cancer lateral neck regional lymph node cleaning the number district number respectively compared with control group,the P values were greater than0.05,there was no statistically significant difference.Experimental cleaning the number of lymph node in central region for(5.24±2.89)and the control group cleaning the number of lymph node in central region(5.04±2.77)compared with P > 0.05,there was no statistically significant difference.(2)the operating time: the operation time is(45.25± 12.35)min,significantly lower than the control group(65.15 ± 14.35)min.Comparing the two groups P < 0.05,the difference was statistically significant.(3)the length of time: the length of hospital stay for(3.26±1.83)d,significantly lower than the control group(5.76 ± 2.58)d.Comparing the two groups P < 0.05,the difference was statistically significant.(4)incision length: the length of incision for(6.75±1.63)cm,significantly lower than the control group(10.37±3.41)cm.Comparing the two groups P<0.05,the difference was statistically significant.(5)Bleeding amount of the intraoperative blood loss for(26.78±5.89)ml,significantly lower than the control group(32.37±16.98)ml.Comparing the two groups P < 0.05,the difference was statistically significant.(6)had the flow: the postoperative total flow for(80.55 ± 21.37)ml,significantly lower than the control group(142.78±17.66)ml.Comparing the two groups P < 0.05,the difference was statistically significant.(7)postoperative drainage time: the experimental group for(3.05±1.24)d,significantly lower than the control group(5.15 ±1.56)d.Comparing the two groups P < 0.05,the difference was statistically significant.(8)Postoperative incision satisfaction: the experimental group patients are very satisfied with 17 cases,satisfaction in 2 cases,are not satisfied in 1case.Control group patients are very satisfied with 10 cases,8 patients were satisfied,not satisfied in 2 cases.Very pleased with incision in the experimental group and the number of patients satisfaction with the control group was impressed with the incision and the number of patients satisfaction were compared,the P values were less than 0.05,the difference was statistically significant.For patients are not satisfied with incision,the experimental group and control group comparison P > 0.05,there was no statistically significant difference.(9)Postoperative complications,postoperative complications of patients with postoperative bleeding,infection of incision,mainly including facial edema,cervical plexus nerve injury,diaphragmatic myoparalysis,horner syndrome,Jian Bei syndrome,chyle leakage,temporary laryngeal nerve damage,temporary laryngeal recurrent nerve injury and temporary parathyroid injury and permanent parathyroid injury,permanent and temporary hypocalcemia hypocalcemia.For the infection of incision,and facial edema,two complications,the experimental group and control group were compared,the P values were less than 0.05,the difference was statistically significant.But the rest of the complications in the two groups respectively to compare the P values were greater than 0.05,there was no statistically significant difference.(10)the experimental group in postoperative follow-up process of regional lymph node recurrence in 2patients,in the process of the control group in the postoperative follow-up of regional lymph node recurrence in 1 patients,comparing the two groups P > 0.05,there was no statistically significant difference.Two groups of patients at follow-up,no local recurrence occurred in the process of comparing the two groups P > 0.05.There was no statistically significant difference.Conclusion:Sternocleidomastoid lateral path in differentiated thyroid cancer lateral neck lymph node cleaning compared with the traditional operation method has obvious advantages,not only can achieve the purpose of curing,and shorten the operation time and hospital stay,reduce the length of incision makes external appearance more beautiful,reduce intraoperative bleeding and postoperative total flow rate,reduce the occurrence of complications such as postoperative incision infection and facial edema,obviously improve the patient's quality of life. |
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