【摘要】 目的 :探讨双侧甲状腺癌外科治疗的术式选择。方法 :对 2 1例双侧甲腺癌病例中 3例进行近全甲状腺切除术 ,18例行全甲状腺切除术。行一侧功能性颈清扫术 5例 ,一侧传统性颈清扫术 2例 ,双侧功能性颈清扫术 7例 ,一侧传统性颈清扫术加对侧功能性颈清扫术 1例 ,双侧传统性颈清扫术 1例。结果 :2 1例随访 2～ 13年 ,平均 5年2个月 ,死亡 1例 ,2 0例无瘤生存。术后无一例出现永久性甲状旁腺功能减退和喉返神经麻痹。结论 :双侧甲状腺癌为多发癌 ,主张行全甲状腺切除术。保持清楚的解剖层次 ,保护喉返神经和甲状旁腺是全甲状腺切除术的关键。如术前发现颈部淋巴结肿大 ,应同时行一侧或双侧颈清扫术 ,对N0 患者不必常规行颈清扫术 ,提倡长期密切观察。更多还原

【Abstract】 Objective: To investigate the optimal extent of primary thyroidectomy and cervical lymphadenectomy in patients with bilateral thyroid carcinoma(BTC) Methods:To analyze retrospectively the data of 21 BTC cases.Subtotal thyroidectomy was performed in 3 cases,total thyroidectomy was performed in 18 cases.Unilateral functional cervical lymphadenectomy was performed in 5 cases and Unilateral traditional cervical lymphadenectomy in 2 cases,bilateral funtional cervical lymphadenectomy was performed in 7 cases,bilateral traditional cervical lymphadenectomy in 1 case.Results:Among 21 patients with followed up period of 2～13 years(average:5 years and 2 months),only 1 case died,20 cases were alive with no evidence of disease(NED).There was no hypoparathyroidism and recurrent nerve paralysis occurred postoperatively.Conclusion:We suggest total thyroidectomy for BTC.Unilateral or bilateral cervical lymphadenectomy should be done if there were Cervical lympho nodes metastasis,but it is not nccessary for No Cases. [更多还原