甲状腺癌改良根治性颈淋巴结清扫术

全麻甲状腺全切+左Ⅱ~Ⅳ区淋巴清扫+中央区淋巴清扫+左侧喉返神经吻合术。切断左胸骨甲状肌上端,辨认喉上神经外支后,切断甲状腺上血管,沿真被膜解离,下极处辨认喉返神经后处理血管,注意保护上下旁腺。全长暴露左侧胸锁乳突肌深面,切开左侧颈鞘,保护副神经,自下而上,自前向后,清扫左侧Ⅱ-Ⅳ区淋巴结,在左侧颈静脉角处注意结扎,防止术后乳糜漏。

Modified Radical Neck Dissection of Thyroid Cancer

Total thyroidectomy +Left levelⅡ~Ⅳneck dissection +central lymph node dissection+Left RLN anastomosis under general anesthesia were performed .By dissecting left upper sternothyroid muscle, left external branch of superior laryngeal nerve was exposed and the superior vessels are cut off and ligated.Along with the true thyroid capsule , the lobe was dissected .The transection of lower vessels was done after proper exposition of the RLN .Both superior and inferior parathyroid tissue were preserved with their own blood supply , then the left lobe was totally removed . The sternocleidomastoid muscle was dissected, then the carotid sheath was unwrapped while protecting nervus accessorius .Lymph nodes of levelⅡ~Ⅳwere dissected radically from inferior to superior and from anterior to posterior .Ligation of the duct is performed carefully in left venous angle to avoid chyle leak .