Abstract: Objective To explore the application of extended isthmus resection combined with lymph node dissection in the central area of the affected side in the treatment of thyroid micro papillary carcinoma with length ≤1cm.Methods The data of 164 patients with thyroid papillary carcinoma treated in Huai'an First Hospital Affiliated to Nanjing Medical University from January 2015 to January 2017 were analyzed retrospectively.According to the operation method,they were divided into control group(74 cases) and observation group(90 cases).The control group received thyroidectomy + isthmus resection on the affected side,and the observation group received thyroidectomy + isthmus resection + central lymph node dissection on the affected side.The operation situation,pharyngeal reflux symptom index (RSI),voice disturbance index (VHI),complication rate and follow-up of the two groups were counted.Results There was no significant difference in blood loss,length of hospital stay,incidence of temporary recurrent laryngeal nerve injury,incidence of hypocalcemia and incidence of parathyroid gland dysfunction between the two groups (P>0.05).There was no significant difference in RSI scores and VHI scores between the two groups before operation and 1 week after operation (P>0.05).The RSI scores and VHI scores of the two groups after 1 week of operation were lower than those before operation (P<0.05).The operation time of the observation group was longer than that of the control group(P<0.05).The 6 month recurrence rate,1 year recurrence rate and 1 year lymph node metastasis rate of the observation group were lower than those of the control group The 3 year survival rate was higher than that in the control group (P<0.05).Conclusion The implementation of isthmus extended resection + central lymph node dissection on the affected side has no effect on the pharynx and sound of patients with thyroid micro papillary carcinoma with length ≤1cm.It can reduce the incidence of complications and recurrence rate without increasing intraoperative blood loss,and can significantly improve the survival rate of patients.

Key words: isthmus expansion resection, central lymph node dissection, thyroid papillary carcinoma, surgery