关键词: 甲状腺肿瘤, 乳头状癌, 颈淋巴结清扫, 转移

Abstract:

Location and prevention of easily missed metastatic lymph node in cervical lymph node dissection                              ZHANG Hao, SUN Wei.Department of Thyroid Surgery，the First Hospital of China Medical University，Shenyang 110001，China
Corresponding author：ZHANG Hao，E-mail：haozhang@cmu.edu.cn
Abstract    Cervical lymph node metastasis is common in papillary thyroid carcinoma （PTC）. Standard cervical lymph node dissection is helpful to reduce local recurrence rate， reoperation rate and improve the prognosis for PTC patients. However， the anatomical structure of the neck is complicated. Metastatic lymph node is easily missed during surgery  without careful preoperation evaluation， standard dissection extent and skilled surgery technique resulting in the lymph node residual. Lower central lymph node， lymph node posterior to right recurrent laryngeal nerve， level Ⅱb， deeper lymph node of level IV， level V， lymph node between nerve root intersection， lymph node between sternocleidomastoid and sternohyoid muscle and pharyngeal lymph node are the most common missed locations during cervical lymph node dissection. Preoperative enhanced CT is helpful for the diagnosis and localization of metastatic lymph node. Familiar with the location of missed metastatic lymph node， accurate preoperation evaluation， standard dissection extent and skilled surgery technique are the key points avoiding lymph node residual during cervical metastatic lymph node dissection.

Key words: thyroid neoplasms, papillary carcinoma, neck dissection, metastasis