Abstract:

The significance of level VI compartment dissection for the treatment of papillary thyroid carcinoma        ZHANG Hao. Department of General Surgery, the First Hospital of China Medical University, Shenyang 110001, China
Corresponding author: ZHANG Hao，E-mail: haozhang@mail.cmu.edu.cn
Abstract    The level VI compartment of the neck is the most common site of local metastasis for papillary thyroid carcinoma. Level VI compartment dissection is routinely performed on cN1 patients, but whether cN0 patients need routine level VI compartment dissection remains controversial. A lot of studies have indicated that the significance of level VI compartment dissection in surgical operation for cN0 papillary thyroid carcinoma. Routine level VI compartment dissection may be helpful to remove occult level VI lymph nodes metastasis, reduce the recurrence and improve the survival of papillary thyroid carcinoma patients，reduce the rate of later cervical nodes metastasis, has a certain potential predictive value for the recurrence of papillary thyroid carcinoma, staging, post-operative comprehensive treatment and follow-up. Meanwhile, it can also avoid the damage of recurrent laryngeal nerve in re-dissection; reduce the need for reoperative dissections and the complication of surgery. Therefore, we advocate that the level VI compartment dissection could be performed as routine for the treatment of cN0 papillary thyroid carcinoma and complication could be decreased by improving surgical skills.

Key words: thyroid carcinoma, papillary carcinoma, level VI lymph node, neck lymph node dissection

摘要：

Ⅵ区淋巴结是甲状腺乳头状癌最常见的转移部位，对cN1病人行Ⅵ区淋巴结清扫已没有异议，但对cN0病人是否常规行Ⅵ区淋巴结清扫还存在一定的争议,而现有资料表明常规进行Ⅵ区淋巴结清扫术对cN0甲状腺乳头状癌病人具有重要的临床意义。常规进行Ⅵ区淋巴结清扫术有利于彻底切除隐匿性的转移淋巴结、减少肿瘤复发和改善存活率，降低颈侧方的淋巴结转移发生率，有利于肿瘤的准确临床分期，对制定术后综合治疗和随访方案、评估术后复发危险性以及判断预后有重要价值，同时能够避免再次手术时损伤喉返神经，降低手术并发症发生率。因此，我们提倡对cN0甲状腺乳头状癌病人在根治原发灶的基础上常规进行Ⅵ区淋巴结清扫术，对解剖结构的熟悉和手术技巧的熟练是预防该手术并发症的关键。

关键词: 甲状腺肿瘤, 乳头状癌, Ⅵ区淋巴结, 颈淋巴结清扫术