甲状腺乳头状腺癌选择性颈清扫术后并发症

Complications related to selective neck dissection for papillary thyroid carcinoma

目的探讨甲状腺乳头状腺癌选择性颈清扫(selective neck dissection,SND)术后并发症的发生原因及预防措施。方法回顾性分析94例行甲状腺乳头状腺癌SND的患者的临床资料。结果颈后外侧淋巴清扫术(posterolateral neck dissection,PLND)组29例;PLND+甲状腺次全切除术组16例;PLND加颈前清扫(anterior compartment neck dissection,ACND)加甲状腺次全切除术组34例;PLND加ACND加甲状腺全切除术组15例。副神经损伤发生率为9.6%,喉返神经损伤发生率为10.7%,6例患者出现了乳糜漏,6例出现术后甲状旁腺功能减退。结论甲状腺乳头状腺癌SDN并发症发生率较低,手术是比较安全的。

OBJECTIVE To explore the causes and preventive measures of complications related to selective neck dissection （SND） for papillary thyroid carcinoma. METHODS The clinical data of 94 patients with papillary thyroid carcinoma underwent SND were retrospectively studied. RESULTS Twenty nine patients underwent posterolateral neck dissection （PLND） alone, whereas 16 patients underwent simultaneous PLND and near total thyroidectomy, 34 patients underwent simultaneous PLND, anterior compartment neck dissection and near-total thyroidectomy, 15 patients underwent simultaneous PLND, anterior compartment neck dissection and total thyroidectomy. Spinal accessory injury and recurrent laryngeal nerve palsy occurred in 9.6 % and 10.7 % patients respectively after operation. Six patients developed chyle leaks. Hypoparathyroidism occurred in 6 patients. CONCLUSION The SND is safe with acceptable morbidity for papillary thyroid carcinoma.