分化型甲状腺癌再次手术原因探讨(附82例病例报告)

目的　探讨分化型甲状腺癌的术前正确诊断和合理的手术术式选择。方法　对 82例分化型甲状腺癌再次手术的临床资料进行回顾性分析。结果　术前 69例误诊为甲状腺瘤 ,11例误诊为结节性甲状腺肿。首次手术行单纯性肿瘤切除 5 9例 ,患叶甲状腺次全切除 13例 ,9例行腺叶加峡部切除。术前、术中 80例未做细胞及病理学检查。结论　对甲状腺结节患者 ,应行细针穿吸 (FNAC)及术中冰冻切片 (FS)检查。并重视区域淋巴结的检 (探 )查 ,以确定分化型甲状腺癌诊断 ,根据病期选择手术术式。如无条件行FNAC及FS ,对一叶单发或多发甲状腺结节的可疑病例 ,宜选择甲状腺叶加峡部切除术术式治疗

The reasons of reoperation on differentiated thyroid cancer

Objective To explore the correct pre-operative diagnosis of differentiated thyroid cancer and choice of reasonable operation methods.Methods The clinical data of 82 reoperaive cases with differentiated thyroid cancer were analyzed retrospectively. Results sixty nine cases were misdiagnosed as thyrophyma and 11 cases were misdiagnosed as nodular goiter before first operation. the tumor resection was performed in 59 cases, the subtotal lobectomy was performed in 13 cases and the lobectomy plus inthmusectomy was performed in 9cases at first operation. Eighty cases were not carried out cytology and pathological identification before and during first operation. Conclusion FNAC and FS should be done on thyroid nodule patients, more attention should be paied to local lymphodes in order to ensure the diagnosis of differentiated thyroid cancer and to choose the operation methods according to stages of disease. It's proper to choose lobectomy plus isthmusectomy in uncertained cases with single or multiple thyroid nodules if FNAC and FS are impossible.