颈前弧形切口甲状腺癌中央区淋巴结清扫术的可行性分析

Arc incision in the frontal neck for lymphadenectomy of the central compartment in differentiated thyroid carcinoma

目的:探讨临床Ⅰ、Ⅱ期分化型甲状腺癌患者行颈前弧形切口中央区淋巴结清扫术的可行性。方法:回顾分析56例Ⅰ、Ⅱ期分化型甲状腺癌患者采用颈前弧形小切口,行中央区淋巴结清扫术治疗结果。结果:56例患者颈淋巴结3年复发率为3.6%。低钙抽搐1例(1.8%),对症治疗6个月后缓解;声音嘶哑1例(1.8%),3个月后恢复。无死亡病例,亦无皮瓣坏死,所有患者术后均有亚临床甲状腺功能低下,经口服优甲乐后得以纠正。结论:Ⅰ、Ⅱ期分化型甲状腺癌患者行颈前弧形切口中央区淋巴结清扫术,手术疗效满意,外形美观,术后患者生活质量高。此术式值得推广。

Objective ： To discuss the possibility of using arc incision in the frontal neck for local-regional lymph excision in differentiated thyroid carcinoma of stage Ⅰ andⅡ. Methods ： A retrospective study was conducted on the results of the treatment of 56 cases of differentiated thyroid cancer in stage Ⅰ and Ⅱ treated by thyroid lobectomy ＋ isthmectomy ＋ local-regional lymph nodes dissection. Results： Of all the 56 patients, only 2 developed postoperative complications, 2 had cervical lymph nodes metastases after the operation, and none died. Conclusion： Arc incision in the frontal neck for lymphadenectomy of the central compartment could be applied as a routine treatment of differentiated thyroid carcinoma in stage ⅠandⅡ.