甲状腺癌近期内再手术探讨

目的探讨甲状腺癌近期内再手术的原因、手术指征、手术时机及手术方式.方法回顾性分析1994年1月～2003年6月间33例甲状腺癌患者3个月内再手术的临床资料.结果再手术中发现甲状腺癌残留14例,其中伴颈部淋巴结转移4例,对侧甲状腺腺瘤残留2例.22例获得随访,随访时间6个月～9年,中位随访时间4年,本组未出现肿瘤复发.结论甲状腺癌首次手术时漏诊、误诊及首次手术切除范围不足是导致近期内再手术的主要原因.对明确有再手术指征者,手术应尽早进行.再手术时应选择适当的手术方式,以提高患者的长期生存率,减少并发症的发生.

Short-term reoperation of thyroid cancer

Objective To investigate the cause,the indication,the timing and operative procedure of short-term reoperation for thyroid carcinoma.Methods A retrospective analysis was made on the clinical data of reoperation within 3 months in 33 cases of thyroid carcinoma from January 1994 to June 2003.Results Four-teen patients were found to have residual cancer in thyroid and its surrounding tissue. Four of them had cervical lymph node metastasis and 2 were found to have adenoma in contralateral thyroid.Twenty-two cases were followed-up for 6 months to 9 years(mean=4 yrs) after secondary operation, there was no carcinoma recurrence.Conclusions The main causes of short-term reoperation for thyroid carcinoma were missed diagnosis or misdiagnosis at the first operation and incorrect original operative procedures. Reoperation should be performed as early as possible when the indication for surgical reintervention was confirmed. Meanwhile, a proper procedure should be chosen to increase the long-term survival rate and reduce the occurrence of complications.