Effect of thyroid mesangectomy on the recurrence and metastasis rates of thyroid papillary carcinoma patients

Objective To investigate the effects of thyroid mesangectomy on lymph node dissection in central region of thyroid papillary carcinoma patients, and its influence on long-term prognosis.

Methods One hundred and forty thyroid papillary carcinoma patients treated with radical thyroidectomy were divided into the observation group (50 cases treatment with thyroid mesangectomy) and control group (90 cases treatment with conventional central lymph node dissection).The surgical indexes, postoperative complications, and serum levels of postoperative parathyroid hormone (PTH) and calcium were compared between two groups.The patients were followed up to January 2019, and the recurrence and metastasis rate was compared between two groups.

Results The operation time in observation group was significantly longer than that in control group (P < 0.01).There was no statistical significance in the amount of intraoperative blood loss, postoperative hospital stay and postoperative ambulation time between two groups (P>0.05).There was no statistical significance in the serum levels of PTH and calcium between two groups before and after operation, and the difference of postoperative complications was not statistically significant (P>0.05).No patients in the observation group received secondary surgery, while 1 patient in the control group received secondary surgery, and the difference of which was not statistically significant (P>0.05).During the following up of 24 to 60 months, the recurrence and metastasis rate in observation group was lower than that in control group (P < 0.05).The results of multivariate analysis showed that the TNM staging, extraglandular invasion, lymph node metastasis and thyroid mesangial resection were the independent factors influencing the recurrence and metastasis rate of thyroid papillary carcinomas (P < 0.05).

Conclusion The short-term efficacy of thyroid mesangectomy is comparable to that of conventional central lymph node dissection.The long-term recurrence and metastasis rate is lower, and the long-term prognosis is better.