[En-bloc resection of thyroid cancer using recurrent laryngeal nerve tunnel dissection combined with mesangectomy: a retro-spective analysis of 174 cases].
Source: PubMed, NCBI / U.S. National Library of Medicine
To evaluate the application value of recurrent laryngeal nerve tunnel dissection combined with mesangectomy in en-bloc resection for thyroid cancer. A retrospective analysis was conducted on 174 patients with thyroid cancer diagnosed by preoperative fine-needle aspiration cytology who underwent surgery at Shaoxing Central Hospital from January 2020 to May 2024. These patients (modified surgery group) received en-bloc resection using recurrent laryngeal nerve tunnel dissection combined with mesangectomy, including 143 cases of unilateral radical thyroidectomy, 24 cases of bilateral radical thyroidectomy, and 7 cases of isthmus thyroidectomy. A total of 178 patients diagnosed by preoperative fine-needle aspiration cytology who underwent conventional two-step surgery by the same surgical team during the same period were selected as the conventional surgery group, including 160 cases of unilateral radical thyroidectomy and 18 cases of bilateral radical thyroidectomy. All surgeries were completed successfully. Compared with the conventional surgery group, the modified surgery group showed superior outcomes in terms of operation time, intraoperative blood loss, postoperative drainage duration, and postoperative drainage volume in patients undergoing unilateral radical thyroidectomy; temporary recurrent laryngeal nerve palsy and autologous parathyroid gland transplantation rate in patients undergoing bilateral radical thyroidectomy; as well as length of hospital stay, number of cent
Abstract
To evaluate the application value of recurrent laryngeal nerve tunnel dissection combined with mesangectomy in en-bloc resection for thyroid cancer. A retrospective analysis was conducted on 174 patients with thyroid cancer diagnosed by preoperative fine-needle aspiration cytology who underwent surgery at Shaoxing Central Hospital from January 2020 to May 2024. These patients (modified surgery group) received en-bloc resection using recurrent laryngeal nerve tunnel dissection combined with mesangectomy, including 143 cases of unilateral radical thyroidectomy, 24 cases of bilateral radical thyroidectomy, and 7 cases of isthmus thyroidectomy. A total of 178 patients diagnosed by preoperative fine-needle aspiration cytology who underwent conventional two-step surgery by the same surgical team during the same period were selected as the conventional surgery group, including 160 cases of unilateral radical thyroidectomy and 18 cases of bilateral radical thyroidectomy. All surgeries were completed successfully. Compared with the conventional surgery group, the modified surgery group showed superior outcomes in terms of operation time, intraoperative blood loss, postoperative drainage duration, and postoperative drainage volume in patients undergoing unilateral radical thyroidectomy; temporary recurrent laryngeal nerve palsy and autologous parathyroid gland transplantation rate in patients undergoing bilateral radical thyroidectomy; as well as length of hospital stay, number of central lymph nodes dissected, and number of level IVB lymph nodes dissected (all<0.05). As of May 25, 2026, the follow-up period ranged from 15 to 77 months. No adverse events such as recurrence of thyroid cancer were reported in any patient. The modified en-bloc resection of thyroid cancer using recurrent laryngeal nerve tunnel dissection combined with mesangectomy is convenient to perform, achieves thorough lymph node dissection with less intraoperative bleeding, and provides reliable protection of the recurrent laryngeal nerve and parathyroid glands. It is worthy of clinical application.