双侧甲状腺癌外科诊治分析

Diagnostic analysis on surgical treatment to bilateral thyroid carcinoma

目的探讨双侧甲状腺癌的诊断与外科治疗。方法回顾分析36例双侧甲状腺癌外科治疗临床资料。结果术后行蜡切片均证实为双侧甲状腺癌，11例双侧淋巴结转移，18例一侧有淋巴结转移。术后未出现永久性甲状旁腺功能减退。无颜面部水肿。4例喉返神经麻痹，2例2周内恢复，2例未恢复。1例淋巴瘘。36例随访4个月～10年，24例无瘤生存，4例出观颈部淋巴结转移，3例死亡。结论双侧甲状腺癌主张行双侧甲状腺腺叶全切除。对非微小癌应常规行改良颈淋巴结清扫术。

Objective To evaluate the bitaleral thyroid carcinoma diagnosis and surgieal treatment. Methods The elinical data of 36 cases of bilateral thyroid carcinoma of surgical treatment was retrospectively analyzed. Results All cases were confirmed as Bilateral thyroid carcinoma by paraffin seetion post-operatively, 11 eases had metastasis in hilaleral lymph nodes, and 21 cases with metastasis in unilateral lymph nodes. No permanent hypo-paralhyroidism or facial edema occurred. Other postoperative complications ineluded recurrent laryngeal nerve paralysis which was resolved 2 weeks later in 4 cases, lymphatic fistula in 1 ease. 36 eases were followed up from 4 months to 10 years post-operatively, with tmnor-free sarvival in 24 eases, and cervical lymph node metastasis in 4 eases and death in 3 eases. Conclusion Total thyroideetomy is advised for Bilateral thyroid carcinoma. It is necessary to emphasize the ilnporlance of functional radical neck dissection in non-microeareinoma.