Discussion of the operative methods for papillary thyroid carcinoma in isthmus        SHAO Tang-lei*，WANG Yang，WU Zhi-hao，et al. *Department of Surgery，Ruijin Hospital，Shanghai Jiaotong University School of Medicine，Shanghai 200025，China
Corresponding author：YANG Wei-ping，E-mail：yangweipingmd@126.com
Abstract    Objective    To discuss the operative methods for papillary thyroid carcinoma in isthmus.   Methods    The clinical data of 28 cases of papillary thyroid carcinoma in isthmus treated from January 2007 to December 2011 at Ruijin Hospital and Yuanyang Hospital of Shanghai Jiaotong University School of Medicine were analyzed retrospectively. Results    The metastasis of bilateral central lymph nodes was found in 20 of 28 cases（71.43%）. No metastasis of bilateral central lymph nodes was found in 8 of 28 cases（28.57%）. Among 13 cases of preoperative bilateral multiple thyroid nodules, 9 cases had nodular goiter and 4 cases had chronic lymphocytic thyroiditis accompanied with bilateral nodular goiter including 1 case of thyroid microcarcinoma. Three cases of preoperative unilateral multiple nodules had nodular goiter. There were transient vocal hoarseness in 3 cases and transient hypocalcemia in 7 cases. Conclusion   Bilateral central lymph node dissection is essential for papillary thyroid carcinoma in isthmus. Total thyroidectomy should be performed for bilateral multiple thyroid nodular. For single nodule in isthmus or multiple nodules in unilateral lobe, bilateral subtotal thyroidectomy or lobectomy in the nodular lobe and the subtotal lobectomy in the normal should be performed to reduce the incidence of postoperative complications.