探讨预防性右侧喉返神经深层淋巴（LN-prRLN）清扫术在右侧甲状腺乳头状非微小癌术中的意义。

回顾性分析中山大学孙逸仙纪念医院甲状腺外科2013年1月至2014年12月395例右侧甲状腺乳头状非微小癌行中央区淋巴结（CCLN）清扫术的患者资料，根据术中是否行清扫术分为清扫组和未清扫组，其中清扫组205例，非清扫组190例。统计两组患者CCLN及LN-prRLN的转移情况。

清扫组发生CCLN转移53.17%，非清扫组51.58%，差异无统计学意义（χ²=3.34，P=0.345）。清扫组LN-prRLN转移率为14.15%,低于中央区其他部位淋巴转移率（53.17%），差异有统计学意义（χ²=0.57，P=0.001）。清扫组患者的平均中央区阳性淋巴结为（6.7±1.4）个，而非清扫组为（5.2±1.4）个，差异有统计学意义（t=0.38，P=0.036）。两组患者均未出现永久性声嘶或永久性甲状旁腺功能低下。清扫组和非清扫组各有5例患者出现暂时性声嘶，差异无统计学意义（2.44% vs 2.63%，χ²=0.01，P=0.939）；暂时性甲状旁腺功能低下发生率分别为17.07%（35/205）和9.47%(18/190)，差异有统计学意义（χ²=0.42，P=0.027）。

LN-prRLN是右侧甲状腺乳头状非微小癌的淋巴转移好发位置之一，预防性行LN-prRLN清扫术增加了CCLN的阳性检出率，并可使分期更为准确。

To investigate the role of prophylactic dissection of lymph node posterior to right recurrent laryngeal nerve (LN-prRLN) of non-minimal papillary carcinoma in the right lobe of thyroid gland.

A retrospective analysis of three hundred and ninety-five patients was conducted of non-minimal papillary thyroid carcinoma in the right lobe from January 2013 to December 2014 of Sun Yat-sen Memorial Hospital. The patients were divided into prophylactic dissection group (205 cases) and non-prophylactic dissection group (190 cases). Central compartment lymph node (CCLN) metastasis and LN-prRLN was analyzed in the two groups.

CCLN metastasis was found in 53.17% of prophylactic dissection group, and in 51.58% of non-prophylactic dissection group, with no significant difference (χ²=3.34, P=0.345). In prophylactic dissection group, 14.15% of LN-prRLN was found invasive, which was lower than other parts of central compartment lymph node district (53.17%, χ²=0.57, P=0.001). Averagely, (6.7±1.4) CCLNs were found in prophylactic dissection group, whereas (5.2±1.4) in non-prophylactic dissection group, which was significantly different (t=0.38, P=0.036). Neither permanent hoarse nor hypoparathyroidism was found in the two groups, but each group had 5 cases of transient hoarse with no statistically significant differences. Transient hypoparathyroidism was 17.07% (35/205) and 9.47% (18/190) in prophylactic dissection group and non-prophylactic dissection group, which had significant difference (χ²=0.42, P=0.027).

LN-prRLN metastasis of non-minimal papillary carcinoma is not uncommon, while prophylactic dissection of LN-prRLN can increase detected positive metastatic rate of CCLN.