本文選題：甲狀腺腺葉切除術(shù)　切入點(diǎn)：頸淋巴結(jié)清掃術(shù)　出處：《中國(guó)微創(chuàng)外科雜志》2017年09期 　論文類型：期刊論文

【摘要】：目的探討甲狀腺微小乳頭狀癌手術(shù)的治療方法。方法 2015年1月~2016年5月,我科收治甲狀腺微小癌126例,行患側(cè)加峽部切除或甲狀腺全切除術(shù)及中央?yún)^(qū)淋巴結(jié)清掃術(shù),中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移者行同側(cè)選擇性區(qū)域淋巴結(jié)清掃術(shù)。統(tǒng)計(jì)手術(shù)并發(fā)癥、術(shù)后病理及恢復(fù)情況。結(jié)果發(fā)現(xiàn)隱匿性多發(fā)癌4例;術(shù)中證實(shí)中央?yún)^(qū)轉(zhuǎn)移45例(35.7%),行橫行小切口側(cè)頸區(qū)選擇性區(qū)域淋巴結(jié)清掃術(shù)(清掃Ⅱ、Ⅲ、Ⅳ、部分Ⅴ區(qū)),術(shù)后病理側(cè)頸區(qū)淋巴結(jié)轉(zhuǎn)移23例。術(shù)后聲音嘶啞3例,飲水嗆咳2例,短暫性低鈣血癥15例(均為甲狀腺全切除術(shù)后),術(shù)后乳糜淋巴漏4例(均為側(cè)頸區(qū)淋巴結(jié)清掃術(shù)后)。無(wú)術(shù)后切口出血導(dǎo)致再次手術(shù)。結(jié)論甲狀腺微小癌具有較高的中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移率,中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移者側(cè)頸區(qū)淋巴結(jié)轉(zhuǎn)移率高,建議對(duì)甲狀腺微小癌行常規(guī)小切口甲狀腺全切除及選擇性區(qū)域淋巴結(jié)清掃術(shù)。
[Abstract]:Objective to investigate the treatment of thyroid micropapillary carcinoma from January 2015 to May 2016. Methods from January 2015 to May 2016, 126 cases of thyroid microcarcinoma were treated by resection of the affected side plus isthmus, total thyroidectomy and central lymph node dissection. Patients with central lymph node metastasis underwent ipsilateral selective regional lymph node dissection. 45 cases of central region metastasis were confirmed during the operation. Selective regional lymph node dissection (鈪，

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