家族性甲状腺髓样癌的外科治疗

目的：一家系中患甲状腺髓样癌(MTC)9例国内甚少见，探讨家族性MTC不同外科治疗方法。方法：回顾总结1991～2002年手术治疗的9例家族性MTC的临床资料。9例家族性MTC中：5例为一次手术，3例二次手术，单纯行患侧甲状腺腺叶切除术7例，2例对侧MTC转移，均行甲状腺局部切除，加同侧颈淋巴清扫术。保留部份组织。结果：1例家族中最年长和1例伴有嗜铬细胞瘤者未手术治疗均死亡，其余均健在，随访最长30余年，最短1年。结论：家族性MTC如单侧者，手术以患侧甲状腺叶切除加峡部切除加同侧淋巴清扫术为宜，如为对侧甲状腺转移，再作对侧甲状腺部份或全部甲状腺切除，同时对侧淋巴结清扫术。本组2例甲状腺对侧转移均行甲状腺部份切除，随访达10年，未见复发，无甲状腺功能低下并发症，取得满意疗兹．

Surgical Treatment of Familial Medullary Thyroid Carcinoma

Objective: It is quite rare that nine MTC sufferers in one familgy. This paper deals with different surgical treatments of familial MTC.Methods: We review the clinic records of the years 1991-2002,when we operated upon nine MTC patients. Five of them received one operation and three got two. Seven patients were given lobectomy and scavenging of the diseased part of the thyroid. Two got a MTC side spread. Both had their thyroid locally removed and cervieal lymph on the same side scavenged and kept part of the thyroid tissue. Results: One of the oldest sufferers and one with pheochromocytoma were not operated and died. The others were still alive. The longest one survived over 30 years and the shortest one year. Conclusion: If a familial MTC lesion is in one side of thyroid, lobectomy is performed, isthmus removal and lymph scavenging on the same side. If MTC is spread, The thyroid is locally or entirely removed and meanwhile lymph nodes on the side scavenged. The two cases concerned suffered from thyroid side spread and had their thyroids partially removed. They have already continued to live for 10 years with no recurrence or hypothyroidism complication and have a satisfactory effect.