中国普通外科杂志2011，Vol.20Issue(5)：443-445,3.
微小乳头状甲状腺癌行颈淋巴结清扫术的必要性探讨
Study on the necessity of neck dissection for papillary thyroid microcarcinoma
裴雷 1陈干农 1周恩相 1谢萍芳 1唐中华1
作者信息
- 1. 中南大学湘雅二医院,乳腺甲状腺外科,湖南,长沙,410011
- 折叠
摘要
Abstract
Objective To evaluate the necessity of neck dissection for papillary thyroid microcarcinoma.Methods The clinicopathologic data of 69 patients with papillary thyroid microcarcinoma treated in our hospital from May 1999 to October 2009 were analyzed. Of the patients, 42 cases were unifocal and 27 cases were multifocal. All patients underwent thyroidectomy and central compartment (level Ⅵ ) and ipsilateral or bilateral deep lymph nodes ( levels Ⅲ and Ⅳ ) dissection. Results In patients of unifocal and multifocal tumor, the metastasis of central compartment lymph nodes was found in 2 ( 4. 8 ％ ) and 7(25.9％ ) cases, and of deep lymph nodes was in 0 (0) and 3 ( 11. 1％ ) cases, respectively. The metastasis rates of central compartment and deep lymph nodes were both significantly different between patients with unifocal and multifocal tumor ( both P ＜ 0.05 ). Four cases of temporary hypocalcemia, three cases of temporary recurrent laryngeal nerve paralysis and one case of lymphatic fistula occurred postoperatively.Recurrence occurred in one unifocal case 42 months later and one multifocal case 7 months later. No death occurred during the follow-up period of all patients. Conclusions Neck dissection should be aggressively performed in patients with multifocal papillary thyroid microcarcinoma. However, prophylactic neck dissection is not necessary for unifocal cases under regularly follow-up care, because that has no influence on the survival rate but can improve quality of life.关键词
甲状腺肿瘤/外科学/微小癌/淋巴结转移/颈淋巴结清扫术Key words
Thyroid Neoplasms/surg/ Microcarcinoma/ Lymphatic Metastasis/ Neck Dissection分类
医药卫生引用本文复制引用
裴雷,陈干农,周恩相,谢萍芳,唐中华..微小乳头状甲状腺癌行颈淋巴结清扫术的必要性探讨[J].中国普通外科杂志,2011,20(5):443-445,3.
