title: Anatomy of mesothyroid: value of mesothyroid excision in thyroid cancer patients.
abstract: OBJECTIVE
  To determine the anatomic distribution of mesentery-like appearance around the thyroid and explore a potential mesothyroid excision for thyroid cancer patients. According to the concept of total mesorectal excision (TME) for rectal cancer, we perform a concept of complete mesothyroid excision for thyroid cancer. Most digestive organs have mesentery. In-depth understanding of mesentery has changed the conceptual framework of surgical treatment and improved management and better outcomes of digestive tumors.
  
  
  METHODS
  The anatomic distribution of the fascia and fascial spaces was studied by dissection of ten specimen fixed in 10% formalin. Thyroid cancer patients (n=5) were included to verify the fascia and fascial spaces during the operation.
  
  
  RESULTS
  The paratracheal fat tissue was found to connect to the pretracheal fat tissue with a structure embedded in two layers of fascia. The two layers of fascia combined with carotid sheath from the outside, while the inside component was connected to the thyroid and considered mesentery.
  
  
  CONCLUSIONS
  The thyroid has mesentery which is located in pretracheal and paratracheal area. An adequate treatment for the patients is the systematic en bloc removal of the tumor and lymph nodes while performing mesothyroid excision.
authors.forename: Shangtong
authors.initials: S
authors.lastname: Lei
authors.forename: Zihai
authors.initials: Z
authors.lastname: Ding
authors.forename: Junna
authors.initials: J
authors.lastname: Ge
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.forename: Guoxin
authors.initials: G
authors.lastname: Li
mesh_terms: D005205:Fascia / Q000033:anatomy & histology*; D000071938:Fasciotomy; D006801:Humans; D008197:Lymph Node Excision; D008643:Mesentery; D013961:Thyroid Gland / Q000196:embryology / Q000473:pathology / Q000601:surgery*; D013964:Thyroid Neoplasms / Q000601:surgery*