甲状腺癌再次手术的原因分析及治疗体会

目的探讨甲状腺癌再次手术治疗的原因及治疗体会。方法回顾分析高要市人民医院1996年1月至2009年12月间16例甲状腺癌再次手术的临床资料,结合文献,研究发生原因、再手术方式要点及治疗体会。结果本组16例再次手术中有9例将甲状腺癌误诊为甲状腺良性病变,占56.3%;5例为首次手术方式选择不当,手术切除范围不够,占31.3%;再次手术后病理切片证实癌细胞残留;2例原因为甲状腺癌术后复发,占12.4%;通过正确合理的手术治疗,取得了良好的效果。结论甲状腺癌的误诊和手术方式选择不当是造成甲状腺癌再次手术治疗的主要原因,提高术者对甲状腺癌的认识水平,强调术中快速冰冻病理检查在甲状腺手术中的常规应用,严格掌握再手术的适应证、选择合理的手术方式、积极预防术后并发症是再次手术成功的关键。

The Causes Analysis and Treatment of Thyroid Cancer Reoperative

Objective To discuss the surgical treatment of thyroid cancer causes and reoperative.Methods Retrospectively analyzed from January 1996～December 2009 in Gaoyao People＇s Hospital once again between the 16 cases of thyroid cancer surgery information,combined with literature,research the causes,and then points and surgical treatment.Results The group of 16 cases of reiteration in 9 cases of thyroid cancer will be misdiagnosed as benign lesions,accounting for 56.3%,surgical resection is not enough,five cases of inappropriate choice for the first surgical procedure,accounting for 31.3%;re-biopsy after surgery confirmed residual cancer cells;two cases of thyroid cancer recurrence causes,accounting for 12.4%,through the right and fair treatment,and achieved good results.Conclusions Thyroid cancer misdiagnosis and surgical thyroid cancer caused by improper selection is the main reason for reiteration,patients who improve the level of awareness for thyroid cancer and emphasized rapid intraoperative frozen pathology during routine application of thyroid surgery,strict control of reiteration indications,to select optimal surgical approach,and actively prevent postoperative complications is the key to successful re-operation.