甲状腺乳头状癌术式的选择(附54例分析)

Operation mode for surgery of thyroid papillary carcinoma(54 cases report)

目的探讨甲状腺乳头状癌合理的手术治疗方法。方法对手术治疗54例甲状腺乳头状癌临床资料进行回顾分析。行患侧腺叶＋峡部切除21例,患侧腺叶＋峡部全切＋对侧大部分切除25例,患侧腺叶＋峡部切除加对侧次全切2例,甲状腺全切6例。均行中央区淋巴结清扫,对9例确诊颈淋巴结转移及10例颈淋巴结肿大者行功能性颈淋巴结清扫。结果术后随访1个月-6年,无死亡病例,暂时性声音嘶哑2例,颈淋巴结转移1例,无甲状旁腺功能不全,未发生远处转移。结论甲状腺乳头状癌的术方宜根据具体情况行患侧腺叶、峡部切除加中央区淋巴结清扫或加行对侧大部（次全）切除及选择性颈淋巴结清扫。

Objective To discuss the operation mode of the thyroid papillary carcinoma.Methods Clinical and histological data of 54 cases with thyroid papillary carcinoma with operation from Jannery 2004 to December 2009 were analyzed retrospectively.Lobectomy and isthmectomy for tumor side and subtotal lobectomy for another side was performed in 2 cases;Lobectomy and isthmectomy for tumor side and partial lobectomy for another side was performed in 25 cases;Lobectomy and isthmectomy was performed in 21 cases;Total lobectomy was perfor medin 6 cases;The Group is sweeping the lymph nodes Central District,the present 9 diagnosed lymph node metastases and 10 cases are present lymph nodes of the present functional cleaning lymph nodes.Results The cases were followed up vistit for one month to six years,no deaths was found in our group,temporary voice hoarse 2 cases,present lymph nodes relapse 1 case,parathyroid gland function garanted in all cases and no distant metastasis found.Conclusion Thyroid papillary carcinoma of the surgical method depending on the circumstances appropriate line of the affected side lobe,isthmus resection and lymph node dissection or additions to the central area contralateral subtotal row（sub-total） resection,and selective neck dissection.