分化型甲状腺癌手术治疗的共识与分歧

Consensus and divergence on surgical treatment for differentiated thyroid cancer

对于分化型甲状腺癌的原发灶切除范围,废弃小于一侧腺叶的手术方式已达成共识,分歧在于是否应对所有病例均行全甲状腺切除或近全甲状腺切除术。关于颈淋巴结清扫术,切除原发灶同时清扫中央区淋巴结以及对临床颈淋巴结阳性病例行颈淋巴清扫术已达成共识,但对临床颈淋巴结阴性病例是否进行颈淋巴结清扫还存在分歧,目前不做清扫术者占主流。

Summary：Agreement has been achieved on cessation to use surgical removal of less than one lobe as to resection extent of primary lesion of differentiated thyroid cancer,whereas divergence remains as to whether near-total or total thyroidectomy should be performed in all patients. For neck dissection, consensus has been reached that concurrent dissection should be clone of central compartment lymph nodes when removing primary lesions and of lateral neck compartment lymph nodes in clinical N1 patients,whereas concurrent dissection of lateral neck compartment lymph nodes in clinical NO patients remains controversial.