Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
Eur Arch Otorhinolaryngol. 2010 May;267(5):807-10. doi: 10.1007/s00405-009-1152-z. Epub 2009 Nov 14.
The aim of this retrospective study was to evaluate the prognostic significance of paratracheal lymph node dissection including hemithyroidectomy for the development of hypo(para)thyroidism. From 1990 to 2004, 169 patients with a carcinoma of the larynx or hypopharynx who underwent paratracheal lymph node dissection were selected. Data of 137 patients (23 women, 114 men) were analyzed. Hundred patients were tested on thyroid function. Patient, tumor and treatment characteristics were noted including age, gender, site, TNM stage and details of surgery, radiotherapy and chemotherapy. Seventy percent of the tested patients had hypothyroidism (36% clinical, 34% subclinical); 33% had hypoparathyroidism. All patients with hypo(para)thyroidism underwent various lymph node treatment modalities. For the various treatment combinations, no increase of hypo(para)thyroidism was found if a bilateral paratracheal lymph node dissection was performed. The incidence of hypo(para)thyroidism after laryngectomy in combination with hemithyroidectomy, neck dissection and paratracheal lymph node dissection is high. An additional risk of paratracheal dissection for the development of hypo(para)thyroidism could not be shown.
本回顾性研究旨在评估包括半甲状腺切除术在内的气管旁淋巴结清扫术对甲状腺功能减退症发生的预后意义。1990 年至 2004 年间，选择了 169 例喉或下咽癌患者进行气管旁淋巴结清扫术。分析了 137 例患者（23 名女性，114 名男性）的数据。100 名患者接受了甲状腺功能检查。记录了患者、肿瘤和治疗特征，包括年龄、性别、部位、TNM 分期以及手术、放疗和化疗的详细信息。70%的检测患者患有甲状腺功能减退症（36%为临床甲状腺功能减退症，34%为亚临床甲状腺功能减退症）；33%患有甲状旁腺功能减退症。所有甲状腺功能减退症患者均接受了各种淋巴结治疗方式。对于各种治疗组合，如果进行双侧气管旁淋巴结清扫术，并未发现甲状腺功能减退症的发生率增加。喉切除术联合半甲状腺切除术、颈部清扫术和气管旁淋巴结清扫术发生甲状腺功能减退症的发生率较高。不能证明气管旁清扫术会增加甲状腺功能减退症的风险。
