摘要
目的总结双侧甲状腺癌的外科治疗方法及疗效。方法回顾性分析32例双侧甲状腺癌的临床资料。4例为双侧甲状腺微小癌，其中3例行双甲状腺次全切除术，1例行甲状腺全切除术；7例合并一侧微小癌，其中1例行甲状腺全切除外，6例行一侧近全切除＋对侧全切除术；余21例中行一侧全切＋对侧近全甲状腺切除术3例，全甲状腺切除术18例。行一侧颈清扫术14例，同期双侧颈总清扫术11例，其中1例因与颈总动脉粘连而有癌灶残留，术后予核素碘治疗。结果32例中除1例失访外，其余随访6月～9年，3例局部复发，其中2例死亡，另1例再次手术痊愈；1例出现远处转移死亡，1例死于其他疾病。结论双侧甲状腺癌甲状腺切除的范围应视癌灶大小和数量以及侵犯程度而定；如伴颈部淋巴结肿大，应同期行颈清扫术。
Objective To summarize the surgical method and effect of synchronous bilateral thyroid carcinoma （BTC）. neitiods Clinical data of 32 BTC were confirmed by pathological examination were reviewed. Of the 4 patients with bilateral thyroid microcarcinoma, 3 were performed subtotal thyroidectomy and 1 was total thyroidectomy. 7 cases with unilateral microcarcinoma underwent unilateral near total plus contralateral total thyroidectomy except 1 of total thyroidectomy. Among the other 21 cases, 18 received total thyroidectomy, and 3 were performed unilateral total plus contralateral near total thyroidectomy. Unilateral radical neck dissection was performed in 14 cases, and simultaneous bilateral radical neck dissection in 8. Results 31 patients were followed up for 0. 5 ～ 9 years. 3 cases occurred local recurrence, of which, 2 died and 1 cured by reoperation. And 1 case died of distal metastasis and 1 died of other disease. The other cases were survived with disease-free. Conclusion The resection range of thyroidectomy is depended on the size, number, and invasion degree of tumor lesion for thyroid carcinoma. Radical neck dissection would be performed when neck lymph node involved.
出处
《中国现代手术学杂志》
2007年第6期435-437,共3页
Chinese Journal of Modern Operative Surgery
