摘要
目的:探讨甲状腺癌再次手术的原因、手术方式的选择和治疗效果。方法:回顾性分析本院2009年4月至2013年4月收治的复发性甲状腺癌的临床资料,总结甲状腺癌再手术的手术方式及喉返神经、甲状旁腺的探查方法。结果:85例患者中,由于首次手术不当而造成癌组织残留55例,占64.7%。术后病理证实为淋巴结癌转移47例,颈部淋巴结转移率55.3%。永久性喉返神经损伤3例(3.5%),甲状旁腺损伤致低钙血症5例(5.9%)。结论:甲状腺癌术中环甲关节区域癌肿的残留是造成复发的主要原因,再次手术中喉返神经入喉区段的完整解离,规范化颈廓清手术及术后1月的131I治疗是确保其成功的关键。
Objective: To discuss the cause of thyroid gland reoperation,choice of the operation style and operation effect. Methods: The recurrent thyroid gland carcinoma patients clinical data were restrospectively analysed. Results:For 85 cases,the carcinoma tissue residues caused by the improper operation style were 55 cases( 64. 7%),the lymph node metastasis confirmed by pathological results were 47 cases,the lymph node metastasis rate was 55. 3%,the eternal recurrent laryngeal nerve injury were 3( 3. 5%),parathyroid gland injury were 5( 5. 9%). Conclusion:During the operation,the remain carcinoma tissue in cricothyroid joint region is the main cause of the postoperative recurrence,the total dissection of the laryngeal recurrent nerve crico- thyroid joint section,formal neck dissection and postoperative131 I treatment in 1 month are the guarantee for the success of operation.
出处
《现代肿瘤医学》
CAS
2016年第6期889-891,共3页
Journal of Modern Oncology
关键词
甲状腺癌
颈廓清
喉返神经
甲状旁腺
thyroid carcinoma
neck dissection
recurrent laryngeal nerve
parathyroidgland