【摘要】 目的探讨甲状腺癌再次手术的必要性及其手术方式。方法回顾性分析我科于1998年2月—2003年10月231例甲状腺癌再次手术的临床资料。结果首次甲状腺肿块切除术62例,行甲状腺腺叶次全切除128例,行甲状腺腺叶加峡部切除术41例。无一例行Ⅵ区淋巴结清扫。首次手术病理类型:乳头状癌158例,滤泡型癌67例,髓样癌6例。根据外院资料及我院B超及CT检查,均再次行手术治疗,其中行甲状腺残叶加峡部切除术55例,行甲状腺残叶加峡部加Ⅵ区清扫87例,单行Ⅵ区清扫9例,行功能性颈淋巴结清扫包括Ⅵ区32例,行甲状腺癌联合根治术23例,行全甲状腺切除加功能性颈淋巴结清扫25例。再次手术后病理证实腺叶中癌残留的132例(69.5%),Ⅵ区淋巴结有转移81例,其中9例行Ⅵ区清扫者均有转移。颈部淋巴结有转移71例。结论甲状腺癌行局部切除术,残癌率高,再次行手术治疗是必要的。更多还原

【Abstract】 Objective To investigate the necessity and methods of reoperation for thyroid carcinoma and analyzed the cause of reoperation.Methods A retrospective analysis was made on the clinical data of reoperation of 231 cases with thyroid carcinoma from Feb.1998 to Oct.2003.Results Among the 231 cases,local mass resection performed on 62 patients,most greater part thyroid performed one lateral total lobectomy plus isthmus of thyroid on 41 patients.Of them,158 patients were papillary cancer,67 were follicular cancer,6 were medullary cancer.According to the data of other hospitals and examination in our hospital,besides neck color B_US or CT,all patients were reoperated.132 cases could find out the residual carcinoma at the primary site(69.5%),81 cases could find out the lymph node of Ⅵ metastasis.71 cases could find out the lymph node metastasis.Conclusions Because of the high residual cancer rate of local mass resection for thyroid carcinoma,reoperation is necessary.更多还原