甲状腺癌再次手术32例分析

Reoperation of Thyroid Recurrence Cancer Clinical Analysis of 32 Cases.

目的探讨甲状腺癌再次手术的原因及再手术方式。方法对32例甲状腺癌再手术患者临床资料回顾分析。结果32例中,原发癌灶残留15例,甲状腺癌根治术后复发或局部淋巴结转移8例,对侧甲状腺及对侧颈淋巴结出现病灶5例,甲状腺微小癌并颈淋巴结转移4例。再手术方式包括:①原发灶残留者行残叶及峡部切除,或加对侧叶次全切除术;②对颈淋巴结转移者,行颈淋巴结清扫术;③对侧甲状腺及对侧颈淋巴结转移者,行对侧甲状腺癌根治术;④对甲状腺微小癌并颈淋巴结转移者,行甲状腺癌根治术。结论对局限于一侧甲状腺叶的甲状腺癌,首次手术至少行患侧甲状腺叶及峡部切除,避免单纯肿瘤摘除术;根治术后复发或局部淋巴结转移,手术仍为主要治疗手段;应重视甲状腺微小癌的诊断和处理。

Objective The cause of reoperatin of the thyroid carcinoma and the operation style were studied . Methods The clinical data of reoperatic 32 patients with recurrent thyroid cancer were analyzed . Results Cancer remain was in 15 cases ; cancer recurrence or with metastasis of neck nodes after surgery in 8 cases ; opposite thyroid and neck node had cancer in 5 cases ; metastasis of neck node of thyroid microcarcinoma in 4 cases , The reoperational style was including ： （1） Primary mass resection and subtotal thyroidectomy ; （2）Neck node dissection ; （3）Radical thyroidectomy . Conclussion Patients with recurrence thyroid carcinoma were treated by reoperatin which selected various style it should be improve the survival rate and quality of life.