甲状腺癌再次手术39例临床分析

Reoperation for Thyroid Carcinoma(An Analysis of 39 Cases)

1985～1995年10年间，住院手术治疗的甲状腺癌患者共119例，其中30例行再次手术。其中5例行甲状腺肿瘤摘除术后，再行残叶切除，3例证实有癌残留（3／5）；行选择性颈淋巴结清除者11例有颈淋巴结转移（11／25）；6例甲状腺隐性癌并颈淋巴结转移者经手术活检证实诊断后行联合根治术；3例甲状腺乳头状癌行联合根治术后颈部复发，再次手术切除。作者认为：对于甲状腺癌首次手术应行患侧腺叶合并峡部切除术，尽量避免肿瘤摘除术；对于侵出包膜的甲状腺乳头状癌可行选择性颈淋巴结清除术；应重视甲状腺隐性癌的诊断；对于行联合根治术后颈部复发的甲状腺乳头状癌，可考虑手术切除配合放疗。

From l985 to 1995,ll9 Patients with thpoid minoma were heated by mpry in our hosptal. of them 39 PatientS were nd by meperation. In 5 cases, the first opewhon was the ewtion of the thyroid neoglastn, and the second was the retion of one lobe of the thpoid gland. The residual orhana hssue was foun by Pathology in 3 cases.The metastatic careinoma in cetwcal lymph nedes was found by Patholop in the samples of selective neck dissechon for ll cases. In 6 cases of thyried edt arim, the fiIs operation was biopsy for cehocal lymph node, and the ed was the edted talical thyridstw.In 3 on of thpoid atinoma with petoperative meonnce, re-eshon was performed. The authors tha that: ① The first operation for the thyroid atinoma should be the reasehon of one lobe and fretum ②For the papillary careinoma the selective neck diwrtion shoul be pebe. ③It ed be for tha the diagnoois of the thwtd occult orinofna is important ④For the neck meonnce of the thpoid orim ther the whted ndical thyIDidectom, the trint should include re-reasehon and ndotherapy.