腔镜分化型甲状腺癌根治术的难点和争议

分化型甲状腺癌具有淋巴结转移率高和患者年轻化的特点，腔镜甲状腺手术因颈部不遗留术后疤痕，近年来发展迅速并广受欢迎。对于存在侧颈部淋巴结转移的分化型甲状腺癌，全腔镜甲状腺癌功能性颈淋巴结清扫给患者带来较好的美容效果及较小的心理创伤。然而，由于该术式工程量大，对术者团队配合要求高。需要把握好手术的适应证和禁忌症。团队的协作、合理灵活运用针式辅助技术是使这该术式得以实现的关键。本文对该术式的技术难点进行阐述，分析腔镜分化型甲状腺癌根治术存在的争议。

Difficulties and controversies of endoscopic radical resection for differentiated thyroid cancer

Clinical characteristics of Differentiated thyroid cancer (DTC) include the high rate of lymph node metastasis and the onset of young patients. With recent development of endoscopic thyroid surgery, neck scar could be avoided, which was increasingly popular. For patients with PTC combined with lateral cervical lymph node metastasis, total endoscopic functional modified neck dissection could achieve better cosmetic outcome with less postoperative psychological trauma. However, these complex surgical procedures require high level of cooperation of surgical team, under certain surgical indications and contradictions. The key of a successful endoscopic thyroid surgery also require skillful application of needle instruments. This article reviewed the difficulties and controversies of endoscopic radical resection for differentiated thyroid cancer.