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目的分析甲状腺癌再次手术的结果,为规范临床甲状腺癌的治疗提供参考。方法回顾性病例对照研究,288例中男69例,女219例,病理类型:乳头状腺癌249例(86.5%),滤泡状腺癌27例(9.4%),髓样癌6例(2%),未分化癌6例(2%)。再次手术时间:1年以内240例(83%)。手术方式有一侧腺叶(或残叶)及峡部切除和(或)对侧腺叶次全切除加一侧颈淋巴结清扫或双侧颈淋巴结清扫。结果残余腺叶有癌组织残存占63例,对侧腺叶有癌肿33例。原发灶同侧颈淋巴结转移164例。结论对甲状腺癌应慎重选择肿瘤切除或腺叶部分切除,同时应重视颈淋巴结转移状态的评估。
Objective To analyze the result of reoperation for thyroid cancer and provide a reference for standardizing the treatment of clinical thyroid cancer. Methods A retrospective case-control study was performed in 288 patients with 69 males and 219 females, pathological types including 249 cases of papillary adenocarcinoma (86.5%), 27 cases of follicular adenocarcinoma (9.4%), 6 cases of medullary carcinoma 2%), undifferentiated carcinoma in 6 cases (2%). Reoperation time: 240 cases (83%) within 1 year. Surgical methods have a glandular leaf (or residual leaf) and isthmic resection and (or) the contralateral gland lobectomy plus one side of the neck lymph node dissection or bilateral cervical lymph node dissection. Results residual gland leaves cancer tissue remnants accounted for 63 cases, 33 cases of contralateral gland lobes cancer. Primary ipsilateral cervical lymph node metastasis in 164 cases. Conclusion Thyroid cancer should be carefully selected tumor resection or partial resection of the leaf, should pay attention to the assessment of cervical lymph node metastasis.