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[分化型甲状腺癌的淋巴结清扫术]

[Lymphadenectomy in the differentiated thyroid carcinoma].

作者信息

Montesani C, Gentili V, Pronio A

机构信息

Università di Roma La Sapienza, VI Clinica Chirurgica.

出版信息

Ann Ital Chir. 2004 May-Jun;75(3):299-303.

Abstract

BACKGROUND

In this study the authors analyze the indications and the type of surgical procedure to perform on the neck lymph nodes in cases of differentiated thyroid carcinoma.

METHODS

The study has been carried in a retrospective way. Between 1993 and 2001, 93 differentiated thyroid cancer were observed. There were 72 women and 21 men, with a mean age of 45.9 years (range 18-77). Patients have been divided into three groups: the first included 25 patients who underwent only thyroidectomy (24 total thyroidectomy, 1 lobectomy); the second group included 52 patients who underwent total thyroidectomy and lymphadenectomy of the central compartment. The third group included 16 patients who underwent total thyroidectomy and functional neck dissection. The median follow-up was 65.9 months.

RESULTS

The postoperative complications was similar between three groups. Follow-up has shown similar survival and recurrences between groups.

CONCLUSIONS

The elective lymphadenectomy of the central could be a solution for a routine treatment of differentiated thyroid cancer without lymph node involvement. The presence of cervico-lateral node metastases imposes a functional neck dissection.

摘要

背景

在本研究中,作者分析了分化型甲状腺癌患者颈部淋巴结手术的指征及手术方式。

方法

本研究采用回顾性研究方法。1993年至2001年间,共观察了93例分化型甲状腺癌患者。其中女性72例,男性21例,平均年龄45.9岁(范围18 - 77岁)。患者被分为三组:第一组包括25例仅接受甲状腺切除术的患者(24例行全甲状腺切除术,1例行叶切除术);第二组包括52例行全甲状腺切除术及中央区淋巴结清扫术的患者;第三组包括16例行全甲状腺切除术及功能性颈清扫术的患者。中位随访时间为65.9个月。

结果

三组患者术后并发症相似。随访显示各组间生存率和复发率相似。

结论

对于无淋巴结转移的分化型甲状腺癌,选择性中央区淋巴结清扫术可能是一种常规治疗方法。存在颈侧区淋巴结转移则需行功能性颈清扫术。

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