Total thyroidectomy plus bilateral central lymph node dissection for bilateral thyroid papillary cancer:an analysis of 33 cases

Objective To discuss the rationality of total thyroidectomy plus bilateral central lymph node dissection for bilateral thyroid papillary cancer.Methods The clinical data of 33 cases of bilateral thyroid papillary cancer performed total thyroidectomy plus bilateral central lymph node dissection from January 2007 to June 2010 at Ruijin Hospital and Yuanyang Hospital of Shanghai Jiaotong University School of Medicine were analyzed retrospectively.Results Among 33 cases,3 cases had unilateral central lymph node metastasis and 23 cases had bilateral central lymph node metastasis.The rate of bilateral central lymph node metastasis was 69.70%(23/33) and the rate of the total central lymph node metastasis was 78.79%(26/33).Six cases(18.18%) developed transient hoarseness.The diameter of the recurrent laryngeal nerves was less than 1 mm.The voice of the cases recovered 3 months after operation.Nine cases(27.27%)developed transient hypocalcemia in whom one case(3.03%) developed permanent hypocalcemia.The ages of the 10 cases were all more than 50 years old,and the parathyroid gland was found in central lymph tissue in 6 cases.Conclusion Although there are some complications after total thyroidectomy plus bilateral lymph node dissection,most of them are transient.Because of the higher lymph node metastasis rate,it is necessary to perform total thyroidectomy plus bilateral lymph node dissection in bilateral thyroid papillary cancer.