ISSN 1004-6879

CN 13-1154/R

 

承德医学院学报 ›› 2019, Vol. 36 ›› Issue (4): 285-287.

• 临床医学 • 上一篇    下一篇

单侧分化型甲状腺癌行双侧中央区淋巴结清扫的临床研究

李东, 严卫忠, 谢华, 刘怡菁   

  1. 上海市安亭医院外科,上海 201805
  • 收稿日期:2019-02-14 出版日期:2019-08-10 发布日期:2021-11-18

CLINICAL STUDY ON BILATERAL CENTRAL LYMPH NODE DISSECTION FOR UNILATERAL DIFFERENTIATED THYROID CANCER

LI Dong, YAN Wei-zhong, XIE Hua, et al   

  1. Surgery Department of Shanghai AnTing Hospital, Shanghai 201805, China
  • Received:2019-02-14 Online:2019-08-10 Published:2021-11-18

摘要: 目的:探讨单侧分化型甲状腺癌行双侧中央区淋巴结清扫术的合理性。方法:80例单侧分化型甲状腺癌患者均实施甲状腺癌根治术联合双侧中央区淋巴结清扫术,分析患者中央区淋巴结转移情况及术后并发症发生情况。结果:80例单侧分化型甲状腺癌,癌灶同侧中央区淋巴结转移32例(32/80,40.0%),对侧中央区淋巴结转移8例(8/80,10.0%),双侧中央区淋巴结同时转移16例(16/80,20.0%),总对侧中央区淋巴结转移率30.0%(24/80),总的淋巴结转移率70.0%(56/80)。术后暂时性低钙血症9例(9/80,11.3%),暂时性喉返神经损伤8例(8/80,10.0%)。80例患者术后随访3年,未发现复发和转移病例。结论:同侧中央区淋巴结是单侧分化型甲状腺癌最易转移的部位,对侧中央区淋巴结也有一定的转移率及跳跃转移的存在。单侧分化型甲状腺癌实施双侧中央区淋巴结清扫能有效清除潜在的转移淋巴结和明确肿瘤是否存在转移,有利于减少术后复发和指导术后分期。

关键词: 单侧分化型甲状腺癌, 双侧中央区淋巴结清扫, 淋巴结转移

Abstract: Objective: To investigate the rationality of bilateral central lymph node dissection for unilateral differentiated thyroid cancer. Methods: 80 cases of unilateral differentiated thyroid cancer patients were all treated with radical thyroidectomy combined with bilateral central lymph node dissection, and the central lymph node metastasis and postoperative complications of patients were analyzed. Results: Among 80 patients, ipsilateral central lymph node metastasis in 32 patients (32/80, 40.0%), contralateral central lymph node metastasis in 8 cases (8/80, 10.0%), simultaneous metastasis of bilateral central lymph nodes in 16 cases (16/80, 20.0%). The total contralateral lymph node metastasis rate was 30.0% (24/80), the total lymph node metastasis rate was 70.0% (56/80). 9 (9/80, 11.3%) patients suffered temporary hypocalcemia, 8 (8/80, 10.0%) patients suffered temporary recurrent laryngeal nerve injury after operation. All the 80 patients were followed up for 3 years without recurrence or metastasis. Conclusions: Ipsilateral central lymph node is the most easily metastatic site of unilateral differentiated thyroid cancer, but contralateral central lymph node also has possibility of metastasis and skip metastasis. Bilateral central lymph node dissection for unilateral differentiated thyroid cancer can remove potential metastatic lymph nodes effectively and determine metastasis of the tumour, which is benefical for reducing recurrence after operation and guiding postoperative staging.

Key words: Unilateral differentiated thyroid cancer, Bilateral central lymph node dissection, Lymph node metastasis

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