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[复发性/持续性分化型甲状腺癌的中央区再次手术]

[Central compartment reoperation for recurrent/persistent differentiated thyroid cancer].

作者信息

Zhang Y B, Zhang B, Yan D G, Zhang X W, Xu Z G, Tang P Z

机构信息

Department of Head and Neck Surgery, Cancer Hospital(Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.

Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Apr 7;52(4):263-266. doi: 10.3760/cma.j.issn.1673-0860.2017.04.005.

Abstract

To analyze the incidences of complications after central compartment reoperation for recurrent/persistent differentiated thyroid cancer, and to investigate the safety and feasiblity of central compartment reoperation. A total of 109 patients who underwent central compartment reoperation for recurrent/persistent differentiated thyroid cancer from January 1, 2011 to March 31, 2016 in Cancer Hospital, Chinese Academy of Medical Sciences was analysed retrospectively, and the incidences of reoperation-related complications were evaluated. Among 109 patients, only 10 (9.2%) patients were treated initially in our hospital and remaining patients (90.8%) treated initially in the other hospitals. Surgical approaches for thyroid beds: 61 patients (56.0%) underwent supplemented total thyroidectomy, 3 patients (2.8%) for removal of recurrent thyroid cancer, 2 patients (1.8%) with supplemented total thyroidectomy and removal of recurrent thyroid cancer, and 12 cases (11.0%) had bilateral thyroid lobectomy. Central compartment lymph node dissection: 66 patients (60.6%) underwent bilateral central neck dissection, 40 patients (36.7%) with unilateral central neck dissection. A total of 16 patients (14.7%) had complications. Transient and permanent vocal fold paralysis developed in 9(8.3%) and 2(1.8 %) patients, respectively. Transient and permanent hypoparathyroidism occurred in 2(1.8%) patients and 11 patients (10.1%), respectively. Postoperative bleeding happened in 1 patient (0.9%). with follow-up from 7 to 61 month, median follow-up was 17.2 months. All patients survived, with recurrence in 3 (2.8%) patients. It seems the incidences of complications for thyroid carcinoma reoperation in central compartment is low for the experienced surgeon. The reoperation was safe and feasible.

摘要

分析复发性/持续性分化型甲状腺癌中央区再次手术术后并发症的发生率,探讨中央区再次手术的安全性和可行性。回顾性分析2011年1月1日至2016年3月31日在中国医学科学院肿瘤医院接受复发性/持续性分化型甲状腺癌中央区再次手术的109例患者,并评估再次手术相关并发症的发生率。109例患者中,仅10例(9.2%)初治于我院,其余患者(90.8%)初治于其他医院。甲状腺床的手术方式:61例(56.0%)患者行补充全甲状腺切除术,3例(2.8%)患者行复发性甲状腺癌切除术,2例(1.8%)患者行补充全甲状腺切除术及复发性甲状腺癌切除术,12例(11.0%)患者行双侧甲状腺叶切除术。中央区淋巴结清扫:66例(60.6%)患者行双侧中央区颈部清扫,40例(36.7%)患者行单侧中央区颈部清扫。共有16例(14.7%)患者发生并发症。分别有9例(8.3%)和2例(1.8%)患者发生暂时性和永久性声带麻痹。分别有2例(1.8%)和11例(10.1%)患者发生暂时性和永久性甲状旁腺功能减退。1例(0.9%)患者发生术后出血。随访7至61个月,中位随访时间为17.2个月。所有患者均存活,3例(2.8%)患者复发。对于经验丰富的外科医生来说,中央区甲状腺癌再次手术的并发症发生率似乎较低。再次手术是安全可行的。

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