多功能保留在甲状腺癌颈淋巴结清扫术中的应用

Application of multifunctional reservation in cervical lymphadenectomy of thyroid carcinoma

目的 探讨多功能保留在甲状腺癌颈淋巴结清扫术中的可行性及意义.方法 回顾性分析我院2006年4月至2009年12月因甲状腺癌行甲状腺切除加Ⅱ～Ⅵ区多功能保留颈淋巴结清扫术61例,4例行双侧颈淋巴结清扫,共65例次.其中甲状腺乳头状癌54例,甲状腺滤泡状癌3例,甲状腺髓样癌4例.结果 61例中保留耳大神经60例次,枕小神经50例次,锁骨上皮神经59例次,颈横动、静脉48例次.术后患者随访0.5～4年,1例术后18个月复发,1例3年复发,59例无复发,术后患者均于3个月内耳廓感觉恢复,下颈部及肩部无麻木感,颈部外观无改变.结论 多功能保留在甲状腺癌颈淋巴结清扫术中应用,既可达到根治肿瘤的目的 ,又能有效保留耳廓区、颈部、锁骨上区的感觉,具合理性、可行性.

Objective To discuss the feasibility and significance of multifunctional reserved cervical lymphadenectomy in thyroid carcinoma. Methods Sixty-five cases of muhifunctional reserved cervical lymphadenectomy of region II to VI in thyroid carcinoma were analyzed from April 2006 to December 2009 retrospectively, four of them were bilateral cervical lymphadenectomy, including 54 cases of papillary, thyroid carcinoma, 3 cases of follicular thyroid carcinoma and 4 cases of medullary thyroid carcinoma. Results Reservation of great auricular nerve were 60 cases, lesser occipital nerve were 56 cases, supraclavicular tegmentary nerve were 58 cases. Follow-up investigation from haft to four years after operation manifested 1 case recurred in the 18th month, 1 case recurred in the third year, no recurrence appeared in 59 cases, sensory function in auricular region recovered well during 3 months after operation in all cases, no insensible feeling occurred in cervical and shoulder, no changes of cervical appearance appeared after surgery. Conclusions muhifunctional reserved cervical lymphadeneetomy can both cure the tumor radically and reserve the feeling in auricular region, cervical and supraclavicular region,which improve the quality of patients living.