中国实用外科杂志2017，Vol.37Issue(9)：941-943,3.DOI:10.19538/j.cjps.issn1005-2208.2017.09.02
分化型甲状腺癌颈侧区淋巴结清扫术若干问题
Several issues concerning lateralcervicallymph nodes dissection for differentiated thyroid carcinoma
徐震纲 1刘绍严 1朱一鸣1
作者信息
- 1. 国家癌症中心中国医学科学院北京协和医学院肿瘤医院头颈外科,北京100021
- 折叠
摘要
Abstract
Papillary thyroid carcinoma (PTC) constitutes the major part of differentiated thyroid carcinoma (DTC).Cervical lymph nodes metastasis is common for PTC.It is essential to treat cervical lymph nodes metastasis rationally and radically.Cervical lymph nodes dissection is currently the best treatment for DTC with cervical lymph modes metastasis.Preoperative evaluation for cervical lymph nodes metastasis should include neck ultrasonography and enhanced computed tomography (CT).Thin slice CT scanning including neck and the thorax is recommended.Enhanced magnetic resonance imaging can substitute CT in case of iodine contrast agent allergy.Indication for lateral cervical lymph nodes dissection is cytology or pathology confirmed lymph nodes metastasis in the lateral neck.Prophylactic lateral cervical lymph nodes dissection is not recommended.The extent of lateral cervical lymph nodes dissection should include levels Ⅱ (Ⅱ a),Ⅲ,Ⅳ,and Ⅴ b.Minimal acceptable extent includes levels Ⅱ (Ⅱ a),Ⅲ,and Ⅳ.When applying the minimal acceptable extent,the indications for dissection of levels Ⅱ b and Ⅴ should be assessed carefully.Based on the radical excision of the disease,more attention should be paid to the protection of nerves and vessels over the dissected region for the improvement of quality of life.关键词
分化型甲状腺癌/甲状腺乳头状癌/颈淋巴结转移癌/颈淋巴清扫术Key words
differentiated thyroid carcinoma/papillary thyroid carcinoma/cervical lymph nodes metastasis/cervical lymph nodes dissection分类
医药卫生引用本文复制引用
徐震纲,刘绍严,朱一鸣..分化型甲状腺癌颈侧区淋巴结清扫术若干问题[J].中国实用外科杂志,2017,37(9):941-943,3.
