甲状腺癌的外科治疗(附33例临床分析)

Surgical Treatment of Thyroid Cancer: Clinical Analysis of 33 Cases

我院自1972年9月~1983年6月共收治甲状腺肿瘤709例,其中甲状腺癌34例占4.8%,33例行手术治疗,并经病理切片确诊.

33 cases of carcinoma of the thyroid were analyzed and reported.The factors which influencing the prognosis,preoperative diagnosis and the surgical procedures were discussed.In estimating the prognosis of carcinoma of the thyroid;the histologic character,size of the lesion and invasiveness of the tumor are more important than the regional lymphatic metastasis.Because of the clinical mis-diagnosis of carcinoma of the thyroid is as high as 78%,it is better to perform a needle biopsy prior the operation whenever there is any suspicion about the nature of a thyroid nodule,or a frozen biopsy during operation.On the otherhand local excision should not be used routinely in the treatment of thyroid adenoma,especially the patient′s age is over 40.There are still some controversies as to the surgical treatment of thyroid care/noma.In our openion the unilateral thyroideetomy or bilateral subtotal thyroideetomy plus modified cervical,lymph node excision(Melvin method)would be considered as the treatment of first choice.