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甲状腺癌二次手术原发灶的切除范围探讨 被引量:7

Re-operation extent of primary lesion of thyroid cancer
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摘要 背景与目的:较多甲状腺癌的患者因为肿瘤的残留而需要行第二次手术,本研究探讨甲状腺癌二次手术原发灶的切除范围。方法:回顾性研究本院收治甲状腺癌患者因手术范围不足,而需再次手术的55例患者,其中男7例,女48例。年龄介于18~56岁,中位年龄33.5岁。所有患者均行患侧甲状腺残叶+峡部+同侧带状肌+同侧Ⅵ区淋巴脂肪组织的切除。结果:术后病理证实有癌残留29例,残留率为52.73%(29/55),其中单纯原发灶残留8例,单纯Ⅵ区淋巴结转移7例,原发灶与Ⅵ区淋巴结同时有残留14例。Ⅵ区淋巴结残留共21例,共有转移的淋巴结45枚,平均每例有转移淋巴结2.14枚,术后病理4例肿瘤细胞与肌肉组织关系密切。结论:患侧甲状腺残叶+峡部+同侧带状肌+同侧Ⅵ区淋巴脂肪组织是甲状腺癌二次手术原发灶的基本切除范围。 Background and Objective. Many thyroid cancer patients need to receive second operation because of tumor residue. This study was to explore the resection extent of primary lesion in re-operation of thyroid carcinoma.Methods. Clinical data of 55 thyroid carcinoma patients who received re-operation were reviewed. The patients, including seven men and 48 women, were aged of 18-56. All patients received ipsilateral residual Iobectomy,isthmectomy, ipsilateral anterior cervical muscle and level VI lymph node dissetion. The optimal extent for radical re-resection of primary lesion was explored. Results. Tumor residue was proved by pathology in 29 patients, with a rate of 52.73%. Of the 29 patients, eight had primary lesion residue, seven had level Vl lymph node residue, and 14 had both. Tumor cells were connected with muscle in four patients. Forty-five metastatic lymph nods were found. Conclusion. Ipsilateral residual Iobectomy, isthmectomy, ipsilateral anterior cervical muscle and level VI lymph node dissetion is the basic re-resection extent of primary lesion for thyroid carcinoma patients.
出处 《癌症》 SCIE CAS CSCD 北大核心 2009年第6期652-654,共3页 Chinese Journal of Cancer
关键词 甲状腺肿瘤 外科手术 二次切除 切除范围 thyroid neoplasm, surgery, re-operation, resection extent
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