CAJ | 학술논문

目的探讨临床颈侧淋巴结阴性(cN0)的甲状腺乳头状微小癌(PTMC)患者行中央组淋巴结清扣术的疗效.方法回顾分析35例cN0的PTMC患者行中央组淋巴结清扫的临床资料,双侧PTMC 3例行甲状腺腺叶全切除术,32例单侧PTMC均行患侧甲状腺腺叶、峡部甲状腺全切及对侧甲状腺腺叶次全切除术,所有病例均行中央组淋巴结清扫术.结果 4例有中央组淋巴结转移.再行改良颈清淋巴结均未及转移;其余31例中央组淋巴结未及转移.1例术后发生左颈部淋巴漏,13例术后出现一过性甲状旁腺功能低下,补钙后缓解,2周后恢复正常;2例喉返神经麻痹.经6～42个月的随访,35例患者均未发现颈部淋巴结转移.结论对cN0的PTMC患者常规行中央组淋巴结清扫有助于改善其生存情况,可以通过提高手术技巧降低手术的并发症发生率.
목적 탐토림상경측림파결음성(cN0)적갑상선유두상미소암(PTMC)환자행중앙조림파결청구술적료효.방법 회고분석35례cN0적PTMC환자행중앙조림파결청소적림상자료,쌍측PTMC 3례행갑상선선협전절제술,32례단측PTMC균행환측갑상선선협、협부갑상선전절급대측갑상선선협차전절제술,소유병례균행중앙조림파결청소술.결과 4례유중앙조림파결전이.재행개량경청림파결균미급전이;기여31례중앙조림파결미급전이.1례술후발생좌경부림파루,13례술후출현일과성갑상방선공능저하,보개후완해,2주후회복정상;2례후반신경마비.경6～42개월적수방,35례환자균미발현경부림파결전이.결론 대cN0적PTMC환자상규행중앙조림파결청소유조우개선기생존정황,가이통과제고수술기교강저수술적병발증발생솔.
Objective To evaluate the effect of the central compartment neck dissection for cNO papillary thyroid mierocarcinoma(PTMC). Methods In 35 cases with oN0 PTMC, total thyroidectomy was performed on 3 bilateral PTMC cases, homolateral lobe and isthmus total thyroidectomy + contralateral lobe near total thyroidectomy was performed on 32 unilateral PTMC cases. The central compartment lymph node dissection was performed on all cases. Results Homolateral functional neck dissection was performed on 4 cases with positive nodes and the specimens were sent for routine histopathological examination which were not found metastasis. There were no such metastasis on the remaining 31 cases. 1 patient was complicated with lymph leakage. 2 patients was complicated with recurrent laryngeal nerve paralysis. 13 patients was complicated with transient postoperative hypoparathyroidism, which returned to normal 2 weeks later with the help of added calcium. 35 patients were followed - up from 6 to 42 months. All the cases were not found metastasis. Conclusions Routine central compartment neck dissection may be helpful to improve the survival of cN0 PTMC patients. Meanwhile, complication could be decreased by improving surgical skills.