关键词: 甲状腺癌, 甲状腺全切术, 精细化被膜解剖, 环甲间隙, 喉返神经

Abstract:

Objective To explore the application value of fine capsule anatomy combined with cricothyroid space exposure of recurrent laryngeal nerve in total thyroidectomy for thyroid cancer patients. Method 90 patients with thyroid cancer in Dongguan Kanghua Hospital from January 2018 to September 2020 were selected. They were randomly divided into two groups, with 45 cases in each group. The control group was treated with conventional total thyroidectomy and inferior thyroid artery exposure of recurrent laryngeal nerve, while the observation group was treated with refined capsule anatomy combined with cricothyroid space exposure of recurrent laryngeal nerve. The operation conditions, changes of thyroid function indexes before and after operation, postoperative complications and recurrence after 6 months of follow-up were compared between the two groups. Result There was no significant difference in the operation time, intraoperative blood loss and the number of lymph node dissection between the two groups (P ＞ 0.05); The detection results of serum parathyroid hormone and Ca2+ in the observation group on 1 day and 3 days after operation were higher than those in the control group, and the difference was significant(P ＜ 0.05); The incidence of recurrent laryngeal nerve injury, hypoparathyroidism and hypocalcemia in the observation group were lower than those in the control group, the difference between the data was significant (P ＜ 0.05); there was no significant difference in the recurrence rate of the two groups after 6 months of follow-up (P ＞ 0.05). Conclusion In total thyroidectomy for patients with thyroid cancer, fine capsule anatomy combined with exposure of recurrent laryngeal nerve in cricothyroid space is beneficial to protect the function of recurrent laryngeal nerve and parathyroid gland.

Key words: Thyroid cancer, Total thyroidectomy, Fine membrane dissection, Annulus between the thyroid rings, Recurrent laryngeal nerve