Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results

BMC Surgery

Wenbin Yu¹  Tianxiao Wang¹  Guohui Xu¹  Yuntao Song¹  Bin Zhang¹  Keneng Chen²  Liang Dai² 

[1] Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing, China;Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), First Department of Thoracic Surgery, Peking University Cancer Hospital and Institute, Beijing, China;

关键词: Thyroid carcinoma;    Video mediastinoscopy;    Mediastinal lymph node metastases;    Mediastinal dissection;    Mediastinal lymphadenopathy;   

DOI  :  10.1186/s12893-021-01326-9

来源: Springer

【 摘 要 】

BackgroundMediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment of thyroid carcinoma with mediastinal lymphadenopathy.Materials and methodsWe retrospectively reviewed the clinical pathologic data and short-term outcomes of thyroid cancer patients with suspicious MLNM treated with video mediastinoscopy-assisted mediastinal dissection at our institution from 2017 to 2020.ResultsNineteen patients were included: 14 with medullary thyroid carcinoma and five with papillary thyroid carcinoma. Superior mediastinal nodes were positive in nine (64.3%) patients with medullary thyroid carcinoma and in four (80.0%) patients with papillary carcinoma. No fatal bleeding occurred. There were three cases of temporary recurrent laryngeal nerve (RLN) palsy postoperatively, one of which was bilateral. Four patients had temporary hypocalcemia requiring supplementation, one had a chyle fistula, and one developed wound infection after the procedure. Postoperative serum molecular markers decreased in all patients. One patient died of cancer while the other 18 patients remained disease-free, with a median follow-up of 33 months.ConclusionVideo mediastinoscopy-assisted superior mediastinal dissection can be performed relatively safely in patients with suspicious MLNM. This diagnostic and therapeutic approach may help control locoregional recurrences.

【 授权许可】

CC BY