Shellenberger Thomas, Fornage Bruno, Ginsberg Lawrence, Clayman Gary L
Department of Head & Neck Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA.
Head Neck. 2007 Mar;29(3):258-66. doi: 10.1002/hed.20513.
Lymph node metastasis from differentiated thyroid carcinoma may occur outside of the basins at greatest risk of spread, such as the lateral retropharyngeal lymph nodes. The extensive surgery of traditional approaches to the retropharyngeal space are rarely justified in the treatment of metastatic differentiated thyroid cancer. Therefore, a less invasive surgical approach is advantageous in resection of metastatic lateral retropharyngeal nodes.
To assess feasibility and safety, we report transoral excision guided by preoperative ultrasonography in a series of 3 consecutive patients with differentiated thyroid cancer metastatic to the retropharyngeal space.
In all cases, the metastatic lateral retropharyngeal lymph node was successfully removed by transoral retropharyngotomy without complications.
We advocate a transoral approach guided by preoperative ultrasonography for resection of differentiated thyroid cancer metastatic to the retropharyngeal lymph nodes. The approach is feasible, minimally invasive, and safe in achieving the goals in management of regionally metastatic disease.
分化型甲状腺癌的淋巴结转移可能发生在扩散风险最高的区域之外，如咽后外侧淋巴结。传统的咽后间隙手术方式范围广泛，在治疗转移性分化型甲状腺癌时很少有充分的理由。因此，一种侵入性较小的手术方法在切除转移性咽后外侧淋巴结方面具有优势。
为评估可行性和安全性，我们报告了在连续3例分化型甲状腺癌转移至咽后间隙的患者中，在术前超声引导下经口切除的情况。
在所有病例中，经口咽后切开术成功切除了转移性咽后外侧淋巴结，无并发症发生。
我们提倡在术前超声引导下采用经口入路切除转移至咽后淋巴结的分化型甲状腺癌。该方法在实现区域转移性疾病管理目标方面是可行的、微创的且安全的。
