论文部分内容阅读
目的探讨分化型甲状腺癌颈淋巴结清扫术的手术入路。方法总结分析2007年10月至2010年1月我院进行颈淋巴结清扫术的分化型甲状腺癌患者的临床资料,其中30例采用颈部3个皮纹小切口,50例采用颈部“L”型刀口进行颈清扫,所有患者均由同一组手术人员完成,并对两组患者手术效果、手术时间、出血量、有无皮瓣坏死、颈部有无积液、颈部水肿程度、瘢痕程度及功能障碍等与手术相关的并发症进行对比。结果采用颈部3个皮纹小切口进行颈清的30例甲状腺癌患者手术均顺利完成,无1例需改用其他方式颈清,手术时间、出血量、颈部淋巴漏未见增多,皮瓣坏死、颈部水肿程度、瘢痕程度及功能障碍明显减少。术后随访8~27月未出现局部及颈部淋巴结复发。结论颈部3个皮纹小切口颈淋巴结清扫术不影响颈淋巴结清扫效果又兼顾了功能与美容,是甲状腺癌淋巴结清扫的一种较为理想的手术入路。
Objective To investigate the surgical approach of cervical lymph node dissection in differentiated thyroid cancer. Methods The clinical data of patients with differentiated thyroid cancer who underwent cervical lymph node dissection in our hospital from October 2007 to January 2010 were analyzed. Among them, 30 cases were treated with 3 small micro-incisions in the neck and 50 cases were treated with neck “L” "Type of incision for neck dissection, all patients were completed by the same group of surgeons, and the two groups of patients with surgical results, operation time, bleeding, with or without flap necrosis, cervical fluid, neck edema, The degree of scarring and dysfunction were compared with surgery-related complications. Results Thirty patients with thyroid cancer underwent cervical trigeminal incision with small incisions on the neck. All the patients underwent thyroidectomy successfully. There was no need to use other methods for neck dissection, operation time, bleeding volume, no increase of cervical lymphatic leakage, Valvular necrosis, neck edema, scarring and dysfunction were significantly reduced. Postoperative follow-up 8 to 27 months did not appear local and cervical lymph node recurrence. Conclusions The 3 small cervical incision neck lymph node dissection does not affect the function of cervical lymph node dissection. It is an ideal surgical approach for lymphadenectomy of thyroid carcinoma.