甲状腺乳头状癌局部切除术后再手术156例临床分析.docVIP

甲状腺乳头状癌局部切除术后再手术156例临床分析 　　【摘要】目的 探讨甲状腺乳头癌局部切除术后再手术的必要性和手术的切除范围。方法 回顾性分析1996年至2009年外科共收治的156例甲状腺乳头状癌局部切除的患者，其中男28例，女128例；年龄20―60岁，以35―50岁为高发年龄段。本组病例术前检查为甲状腺原发灶可疑残留且无颈部淋巴转移的患者，再次手术采用甲状腺残留叶，峡部及同侧带状肌切除，同侧VI区淋巴结清扫。结果 再次手术病理证实，初次手术癌组织残留为68例，残留率为43.3%，其中单纯原发灶残留为38例，单纯VI区淋巴结转移14例，原发灶癌留并VI区淋巴结转移12例，原发灶癌残留及同侧带状肌癌浸润4例。结论 甲状腺乳头状癌局部切除残留率较高，而且有再次手术的必要性；再次手术甲状腺残叶，峡部及同侧带状肌，同侧VI区淋巴组织清扫为基础手术式。 　　【关键词】甲状腺乳头状癌 局部切除术后 癌残留 再次手术。 　　中图分类号：R736.1文献标识码：A文章编号：1005-0515（2010）12-013-03 　　Papillary thyroid reoperation after local resection of the clinical analysis of 156 cases 　　Sun Yan Bin 　　（Mineral Hospital of Jilin Province Jilin, Changchun130061） 　　【Abstract】Objective To study the local resection of thyroid papillary carcinoma of the need for further surgery and surgical excision. Methods A retrospective analysis from 1996 to 2009 were treated 156 surgical cases of thyroid papillary carcinoma patients with local resection, including 28 males, female 128 cases; aged 20-60 years to 35-50 years as the high age. The patients preoperative suspicious thyroid residual primary tumor and no lymph node metastases in patients with thyroid left lobe surgery again, isthmus and removal of the ipsilateral strap muscles, ipsilateral lymph node dissection VI area. The Resultsonce again proved by pathology, the initial residual cancer surgery in 68 patients, residual rate was 43.3%, which left the primary tumor alone, 38 cases of pure VI lymph nodes metastasis in 14 cases, cancer remain the primary tumor and lymph node metastasis VI Region 12 cases, residual cancer primary tumor and ipsilateral infiltrating carcinoma in 4 cases strap muscles. Conclusion The local excision of papillary thyroid carcinoma was higher residues, but also the need for reoperation; thyroid reoperation Grottoes, isthmus and ipsilateral strap muscles, ipsilateral lymph VI Region-based surgical dissection. 　　【Key words】papillary thyroid carcinomalocal resection residual cancer reoperation 　　 　　甲状腺疾病是一种常见的多发的疾病，特别是没有开设病理科的医院