中央区颈淋巴结清扫术对甲状腺微小癌的治疗价值

Evaluation of lymph node dissection in the central neck area in managing thyroid microcarcinoma

目的探讨中央区颈淋巴结清扫术对甲状腺微小癌的治疗价值。方法回顾性分析65例甲状腺微小癌患者的临床资料。结果65例患者中，淋巴结转移阳性率为40％。全程获访的62例患者全部存活，未发现远处转移，复发转移率低，无远期并发症。结论中央区颈淋巴结清扫术是治疗甲状腺微小癌的一种较佳的手术方式。

Objective To evaluate lymph node dissection in the central neck area to treat microsized thyroid carcinoma. Methods The clinical data of 65 surgically treated thyroid microcarcinoma patients in our hospital were retrospectively reviewed. Results In this series, the positive metastasis rate of cervical lymph node was 40%. A total of 62 patients had been followed up until the data were reviewed. None was found to be dead nor having distant metastasis. Five patients were re-operated due to countralateral lobe meatstasis 3 years after initial operation, 2 of them had developed para-tracheal lymph node metastasis; another 2 cases underwent functional neck lymph node dissection due to lymph node metastasis on the operated side 2 years later. Conclusion Thyroidectomy with lymph node dissection of the central neck area is more effective than the thyroidectomy alone for managing thyroid microcarcinoma. It can improve the quality of life and survival through reducing cervical lymph node metastasis.