关键词: 甲状腺乳头状癌 , 中央区淋巴结清扫术, 右侧喉返神经深层淋巴结清扫

Abstract: ［Abstract］ Objective To investigate the necessity and significance of deep laryngeal lymph nodedissection in the operation of papillary thyroid carcinoma. Methods From May 2017 to March 2018，102 cases of thyroid papillary carcinoma （right or bilateral） were treated with radical resection， including lymph node dissection of the superficial and deep layer of the recurrent laryngeal nerve in the right central region. The superficial and deep lymph node metastases were compared after operation. The clinical data of the patients age，sex，tumor size，the invasion of the envelope，the combination of Hashimotos thyroiditis and the lymph node metastasis of the larynx were analyzed and compared with the lymph node metastasis. Results （1）The rate of the deep lymph node metastasis of the right recurrent laryngeal nerve in the central area was 23.5% ，the superficial metastasis was 61.8% ，the proportion of the deep lymph node metastasis only and the non superficial metastasis was 1.3% ，and the total lymph node metastasis rate in the right central area was 65.7%.（2）There was no significant difference in the rate of the deep lymph node metastasis of the recurrent laryngeal nerve in the patient s age，sex，the invasion of the envelope and Hashimoto s thyroiditis，but it was closely related to the size of the lump， the number of lesions，the metastasis of the anterior larynx lymph nodes，and the metastasis of the superficial lymph node of the right laryngeal nerve，P < 0.05. Conclusion On the right or bilateral of a certain rate of the deep lymph node metastasis of the recurrent laryngeal nerve，in order to ensure the radical operation of the radical operation，it is necessary not only to clean the superficial laryngeal nerve，but also to clear the deep lymph nodes，especially when the tumor is larger，multifocal and there is a anterior larynx and superficial lymph node metastases.

Key words: central lymph node dissection, deep lymph node dissection of the right recurrent laryngeal nerve, papillary thyroid carcinoma