546例分化型甲状腺癌手术治疗分析

目的 探讨分化型甲状腺癌的手术治疗方式.方法 回顾性分析2001年1月至2006年12月收治的546例行手术治疗的分化型甲状腺癌患者的临床资料,均行双侧甲状腺全切除术和选择性颈淋巴结清扫术.结果 全组无手术及住院期间死亡.颈部淋巴结转移阳性率为76,2%(358/470).单侧喉返神经损伤的发生率1.1%(6例),双侧喉返神经损伤0例;甲状旁腺部分损伤0.4%(2例),甲状旁腺完全损伤0例;喉上神经损伤0.7%(4例),术后出血0.6%(3例),食管损伤0.2%(1例).结论 对于分化型甲状腺癌患者,均应行双侧甲状腺全切除术;对于肿瘤直径＞1 cm的患者,还应行双侧中央组+患侧颈深组淋巴结清扫.

Operation for differentiated thyroid cancer: a experience of 546 cases

OBJECTIVE: To approach reasonable operational mode of differentiated thyroid cancer. METHODS: Retrospectively review 546 differentiated thyroid cancer patients who received bilateral thyroidectomy with or without cervical lymph node excision from January 2001 to December 2006. RESULTS: No death case happened during operation and hospitalization. The positive percentage of cervical lymph node metastasis was 76.2% (358/470). The incidence rate of single lateral recurrent laryngeal nerve injury was 1.1% (6 cases), parathyroid gland partly injury was 0.4% (2 cases), superior laryngeal nerve injury was 0.7% (4 cases), bleeding was 0.6% (3 cases) and esophagus injury after operation was 0.2% (1 case). There were no bilateral recurrent laryngeal nerve injury found. CONCLUSIONS: Total thyroidectomy is an essential operational mode for differentiated thyroid cancer. It is necessary to excise cervical lymph node when the tumor's diameter exceeds 1 cm.