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全甲状腺切除术:分化型甲状腺癌的首选治疗方法。

Total thyroidectomy: the treatment of choice in differentiated thyroid carcinoma.

作者信息

Shrestha S K, Joshi M R, Sharma S K

机构信息

Department of Surgery, Kathmandu Medical College, Sinamangal, Kathmandu, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2005 Jan-Mar;3(1):35-8.

Abstract

INTRODUCTION

Clinically detectable thyroid carcinoma constitutes less than 1% of human cancers. Ninety percent of all thyroid malignancies are differentiated papillary and follicular carcinoma. Surgery plays a key role in differentiated thyroid carcinoma as it carries excellent prognosis, lower recurrence rate and low mortality rate but controversy persists for extent of surgery and optimal surgical management of lymph node metastasis.

PATIENT AND METHOD

A retrospective analysis was done for the cases that underwent total thyroidectomy with lymph node dissection for differentiated carcinoma of thyroid in Kathmandu Medical College during two year periods (Oct 2001 to Oct 2003).

RESULT

In our experience with 18 cases of Differentiated Thyroid Carcinoma (DTC) treated with total thyroidectomies and lymph node dissection, papillary carcinoma was predominant with 83% incidence. Disease was prevalent in 50 to 60 year age group. Except two cases of transient hypocalcaemia and few wound related complications, there have been no other complications.

CONCLUSION

Total thyroidectomy with lymph node dissection is safe and effective, so, the treatment of choice in cases of differentiated thyroid carcinoma.

摘要

引言

临床可检测出的甲状腺癌占人类癌症的比例不到1%。所有甲状腺恶性肿瘤中,90%为分化型乳头状癌和滤泡状癌。手术在分化型甲状腺癌中起着关键作用,因为其预后良好、复发率低且死亡率低,但对于手术范围和淋巴结转移的最佳手术管理仍存在争议。

患者与方法

对加德满都医学院在两年期间(2001年10月至2003年10月)因分化型甲状腺癌接受全甲状腺切除术及淋巴结清扫术的病例进行回顾性分析。

结果

在我们对18例接受全甲状腺切除术及淋巴结清扫术治疗的分化型甲状腺癌(DTC)的经验中,乳头状癌占主导,发病率为83%。该疾病在50至60岁年龄组中较为普遍。除两例短暂性低钙血症和少数与伤口相关的并发症外,未出现其他并发症。

结论

全甲状腺切除术及淋巴结清扫术安全有效,因此是分化型甲状腺癌病例的首选治疗方法。

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