甲状腺癌再手术探讨

目的：分析甲状腺癌再次手术的原因,探讨甲状腺癌的诊断和合理的再次手术方式。方法：回顾性分析1996～2007年我院治疗的64例甲状腺癌术后复发患者的临床资料,根据首次手术情况及再次手术前检查决定手术方式。结果：再次手术残癌率60.9%（39/64）,其中原发部位残癌率45.3%（29/64）;5年生存率81.3%（52/64）,8年生存率67.2%（43/64）。结论：术中冰冻切片检查（FS）对临床表现及影像学检查不典型甲状腺癌的确诊和合理选择术式,以及对避免再次手术具有重要意义;对局限一侧腺叶的甲状腺癌,至少应行患侧甲状腺叶及峡部切除,避免不规范手术如单纯肿瘤剜除术;对于术后复发患者,合理选择适当的再手术方式,可以提高生存率并改善患者生活质量。

To Explore the Re-surgery of Thyroid Cancer

Objective： Analysis of thyroid cancer re - surgery and explore the reasons for thyroid cancer diagnosis and reasonable way of thyroid re - surgery. Methods： Retrospective analysis of 1996 -- 2007 in our hospital＇s treatment of 64 cases of thyroid cancer recurrence after surgery in patients with clinical data. According to the first surgery and prior to re - surgery decided to check the situation of operation. Results： The re - operation of residual cancer rate of 60.9 % （39/64）, in which primary site of residual cancer rate of 45.3 % （29/ 64）, 5 - year survival rate of 81. 3 % （52/64）, 8 - year survival rate of 67.2 % （43/64）. Conclusion： Intraoperative frozen secti on（FS）on the clinical and imaging is not typical of thyroid cancer diagnosis and reasonable choice of surgical procedures, to avoid re - operation is of great significance; confined to the side of the leaves of the thyroid gland cancer, at least side trip thyroid isthmus and leaf removal to prevent irregularities such as surgery alone tumor enucleation; recurrence for patients through the choice of an appropriate and reasonable way of re - operation to improve the survival rate of patients and to improve the quality of life.