甲状腺背侧支血管作为解剖标志在甲状腺癌根治性切除术中定位喉返神经的应用OA

Objective:To evaluate the clinical efficacy of using the dorsal thyroidal branch vessels as an anatomical landmark for locating the recurrent laryngeal nerve during radical thyroidectomy for thyroid cancer,and to assess its application value in improving surgical safety,reducing recurrent laryngeal nerve injury rate.Method:A retrospective analysis was conducted on the clinical data of 160 patients who underwent radical thyroidectomy for thyroid cancer at the Second People's Hospital of Guiyang from July 2023 to July 2025.According to the way of finding the recurrent laryngeal nerve during the operation,80 patients who located the recurrent laryngeal nerve with the dorsal thyroidal branch vessels as the anatomical landmark were selected as the observation group,and 80 patients who used the traditional anatomical separation method to find the recurrent laryngeal nerve were selected as the control group.The relationship between the dorsal thyroidal branch vessels and the recurrent laryngeal nerve in the observation group was statistically analyzed.The intraoperative blood loss,operative time,and incidence of recurrent laryngeal nerve injury were compared between the two groups.Result:In the observation group,the dorsal thyroidal branch vessels were closely adjacent to the recurrent laryngeal nerve in 56 cases(70.0%),crossed adjacent in 18 cases(22.5%),and relatively separated in 6 cases(7.5%).Compared with the control group,the observation group had less intraoperative blood loss[(62.75±11.68)mL vs(43.22±8.54)mL]and shorter operation time[(109.37±17.64)min vs(91.56±15.22)min].The incidence of recurrent laryngeal nerve injury was lower(20.0%vs 5.0%)(P<0.05).Conclusion:Using the dorsal thyroidal branch vessels as an anatomical landmark for recurrent laryngeal nerve localization during radical thyroidectomy for thyroid cancer is a simple and effective method that significantly improves surgical safety and efficiency and reduces the risk of recurrent laryngeal nerve injury.