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