中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (05): 417-419.

• 论著 • 上一篇    下一篇

双侧甲状腺乳头状癌行甲状腺全切除加双侧中央组淋巴结清扫33例分析

邵堂雷1，殷佳晗2，吴志浩2，丁    昊2，王    海2，汪    洋1，邱伟华1，陈伟国1，杨卫平1   

  1. 1 上海交通大学医学院附属瑞金医院外科，上海200025；2上海交通大学医学院附属瑞金医院远洋分院外科，上海200031
  • 出版日期:2011-05-01 发布日期:2011-05-30

  • Online:2011-05-01 Published:2011-05-30

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摘要：

目的    探讨双侧甲状腺乳头状癌行甲状腺全切除加双侧中央组淋巴结清扫术的合理性。方法    回顾性分析上海交通大学医学院附属瑞金医院和远洋分院2007年1月至2010年6月收治的33例因双侧甲状腺乳头状癌行甲状腺全切除加双侧中央组淋巴结清扫者临床资料。结果    33例病人，3例有一侧中央组淋巴结有转移，23例双侧中央组淋巴结有转移。双侧中央组淋巴结转移率为69.70%（23/33），总的淋巴结转移率为78.79%（26/33）。术后6例（18.18%）出现暂时性声音嘶哑。其喉返神经或神经内支直径<1mm。3个月后声音均恢复正常；9例（27.27%）术后发生暂时性低钙血症，有1例（3.03%）发生永久性低钙血症。该10例均为年龄>50岁女性病人，其中6例在中央组淋巴组织中发现有甲状旁腺组织。结论    虽然甲状腺全切除加双侧中央组淋巴结清扫术后会出现一定比例并发症，但多为暂时性。因双侧甲状腺乳头状癌有较高的淋巴结转移率，有必要施行这一术式。

关键词: 双侧甲状腺乳头状癌, 甲状腺全切除术, 中央组淋巴结清扫

Abstract:

Total thyroidectomy plus bilateral central lymph node dissection for bilateral thyroid papillary cancer: an analysis of 33 cases        SHAO Tang-lei, YIN Jia-han, WU Zhi-hao, et al. Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025,China
Corresponding author: YANG Wei-ping, E-mail:yangweipingmd@126.com
Abstract    Objective    To discuss the rationality of total thyroidectomy plus bilateral central lymph node dissection for bilateral thyroid papillary cancer. Methods    The clinical data of 33 cases of bilateral thyroid papillary cancer performed total thyroidectomy plus bilateral central lymph node dissection from January 2007 to June 2010 at Ruijin Hospital and Yuanyang Hospital of Shanghai Jiaotong University School of Medicine were analyzed retrospectively. Results    Among 33 cases, 3 cases had unilateral central lymph node metastasis and 23 cases had bilateral central lymph node metastasis. The rate of bilateral central lymph node metastasis was 69.70% (23/33) and the rate of the total central lymph node metastasis was 78.79% (26/33). Six cases (18.18%) developed transient hoarseness. The diameter of the recurrent laryngeal nerves was less than 1 mm. The voice of the cases recovered 3 months after operation. Nine cases （27.27％）developed transient hypocalcemia in whom one case (3.03%) developed permanent hypocalcemia. The ages of the 10 cases were all more than 50 years old, and the parathyroid gland was found in central lymph tissue in 6 cases. Conclusion    Although there are some complications after total thyroidectomy plus bilateral lymph node dissection, most of them are transient. Because of the higher lymph node metastasis rate, it is necessary to perform total thyroidectomy plus bilateral lymph node dissection in bilateral thyroid papillary cancer.

Key words:  bilateral thyroid papillary cancer, total thyroidectomy, central lymph node dissection