分化型甲状腺癌再手术42例分析

Analysis of the Re-operation of 42 Cases with Well-Differentiated Thyroid Carcinoma

１９８５年１月至１９９５年１０月，４２例分化型甲状腺癌施行了再手术治疗。其中男性７例，女性３５例。再手术原因：原发癌灶残留；术后复发；颈淋巴结转移灶残留；对侧甲状腺及对侧颈淋巴结出现癌灶。再手术方式：原发癌灶局切者应再次切除残叶及峡部；对肿瘤侵出包膜者，作者认为应放宽预防性淋巴结清扫术的指征，有淋巴结转移者施行传统性或功能性颈淋巴结清扫术；对侧腺叶出现癌灶或对侧出现颈淋巴结转移者，应做对侧甲状腺癌的根治手术。

From January 1985 to October 1995,42 cases of well-differentiated thyroid carcinoma were re-operated.There were 7 males and 35 females.The causes for re-operation were residue of primary carcinoma,recurrence after operation,residue of lymph node metastasis,recurrence of contralateral lobe and contralateral IWhph node metastasis.Forms of re-operation were as follows:the residual lobe and isthmus of the primary tumor resected should be resected;the preventive neck dissection is feasibe for the extracapsular lesion;with the metastasis of the lymph nodes,functional or classical neck dissection is necessary;a radical operation is proposed to be adequate if contralateral lymph node metastases of recurrence of contralateral lobe occur.