甲状腺单发结节的术式选择

Selection of operative type of thyroid single nodule.

138例甲状腺单发结节均行外科手术治疗.甲状腺癌14例,发生率10.1％.术前只有2例确诊,确诊率14.3％.隐匿型甲状腺癌3例,均与甲状腺腺瘤共存.6例甲状腺癌行单纯结节摘除术后,第二次行补充扩大手术.病理证实4例有癌组织残留.癌残留率66.7％.6例甲状腺癌行单侧甲状腺次全切除术或单侧甲状腺切除术后,有3例施行了第二次扩大手术,病理证实无癌组织残留.认为除甲状腺炎性结节外,单侧腺叶大部切除术或单侧腺叶切除术应成为甲状腺单发结节外科治疗的常规术式,除非术前已确诊为甲状腺癌.

138 cases of thyroid single nodule were all treated by surgery.The thyroid cancer were 14 cases.The occurrence rate is 10.1%.Only 2 cases were diagnosed before operation.The diagnostic rate is 14.3%.The obscure thyroid cancer were 3 cases.Thyroid adenoma and it existed in the same time.After the simple resection of single nodule for 6 cases with thyroid cancer,the second operation was all performed widely.The pathologic analysis proves that there are cancer tissue in 4 cases.The remained rate of cancer tissue is 66.7% After the subtotal thyroidectomy or thyroidectomy for 6 cases with thyroid cancer,the second operation was widely performed in 3 cases.The pathologic analysis proves no cancer tissue.The author suggest,except for nodule of thvroiditis.subtotal thyroidectomy or thyroidectomy should be the routine operative type of thyroid single nodule,unless the thyroid cancer has been definite before operation.