分化型甲状腺癌的外科治疗
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Surgical treatment of differentiated thyroid carcinoma
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    摘要:

    目的:总结分化型甲状腺癌的诊治经验。
    方法:回顾性分析110例分化型甲状腺癌的临床资料。
    结果:全组均行手术治疗辅以内分泌治疗,110例分化型甲状腺癌中,乳头状癌88例(80.0%),滤泡状腺癌22例(20.0%);淋巴结转移者22例(20.0%)。手术方式包括单侧病变行患侧腺叶+峡部及对侧大部切除60例(其中功能性颈清扫12例),患侧腺叶+峡部切除29例(其中功能性颈清扫7例);双侧病变行一侧腺叶+峡部及对侧大部分切除18例(其中功能性颈清扫5例),甲状腺全切除术+双侧颈清扫2例;1例肺转移患者行甲状腺全切及颈部淋巴结清扫术后行131I内放射治疗。98例术后随访,10年生存率91.8%。
    结论:分化型甲状腺癌预后较好,治疗关键是正确选择适当的手术方式。

    Abstract:

    Abstract:Objective:To summaize our experience in surgical treatment of differentiated thyroid carcinoma(DTC).
    Methods :The clinical data and followup results of 110 cases of DTC were retrospectively analysed.
    Results:All of the 110 patients received operation and TSH suppression therapy. Histologic examination after operation revealed papillary thyroid carcinoma(PTC) in 88 cases(80%), follicular thyroid carcinoma in 22 cases(20%), and cervical lymph node metastasis was found in 22 cases(20%). The operative procedure included excision of the affected lobe, isthmus and greater part of the opposite lobe in 51 cases (along with functional cervical dissection in 12 cases); excision of the affected lobe, and isthmus in 29 cases (along with functional cervical dissection in 7 cases); excision of the affected lobe, isthmus and greater part of the opposite lobe in 18 cases (along with functional cervical dissection in 5 cases); total thyroidectomy and bilateral cervical dissection in 2 cases; total thyroidectomy and bilateral cervical dissection with postoperative 131I therapy in 1 case who had lung metastasis. Following up of 98 cases showed the 10year survival rate was 91.8%.
    Conclusions:Differentiated thyroid carcinoma has a good prognosis. Proper selection of surgical procedure is the key point for a good outcome.

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杨力, 瞿昌晶, 詹又华, 吴文美.分化型甲状腺癌的外科治疗[J].中国普通外科杂志,2007,16(11):8-105.
DOI:10.7659/j. issn.1005-6947.2007.11.008

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  • 在线发布日期: 2007-11-25