双侧甲状腺癌外科诊治分析

目的 探讨双侧甲状腺癌的诊断与外科治疗.方法 回顾分析36例双侧甲状腺癌外科治疗临床资料.结果 术后石蜡切片均证实为双侧甲状腺癌,11例舣侧淋巴结转移,18例一侧有淋巴结转移.术后未出现永久性甲状旁腺功能减退,无颜面部水肿.4例喉返神经麻痹,2例2周内恢复,2例未恢复.1例淋巴瘘.36例随访4个月～10年,24例无瘤生存,4例出现颈部淋巴结转移.3例死亡.结论 双侧甲状腺癌主张行双侧甲状腺腺叶全切除.对非微小癌应常规行改良颈淋巴结清扫术.

Diagnostic analysis on surgical treatment to bilateral thyroid carcinoma

Objective To evaluate the bilateral thyroid carcinoma diagnosis and surgical treatment.Methods The clinical data of 36 cases of bilateral thyroid carcinoma of surgical treatment was retrospectively analyzed.Results All cases were confirmed as bilateral thyroid carcinoma by paraffin section post-operatively.11 cases had metastasis in bilateral lymph nodes,and 21 cases with metastasis in unilateral lymph nodes.No permanent hypo-parathyroidism or facial edema occurred.Other postoperative complications included recurrent laryngeal nerve paralysis which was resolved 2 weeks later in 4 cases,lymphatic fistula in 1 case.36 cases were followed up from 4 months to 10 years post-operatively,with tumor-free survival in 24 cases,and cervical lymph node metastasis in 4 cases and death in 3 cases.Conclusion Total thyroidectomy is advised for bilateral thyroid carcinoma.It is necessary to emphasize the importance of functional radical neck dissection in non-microcarcinoma.