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目的 探讨颈淋巴结清扫术在分化型甲状腺癌再手术中的价值 ,指导甲状腺癌再手术的术式选择。方法 回顾性分析 12 2例分化型甲状腺癌再次手术病人中 88例作颈淋巴结清扫术的临床资料。 88例中 ,甲状腺肿瘤局部切除术 38例 ,甲状腺腺叶加峡部切除术 16例 ,全甲状腺切除 2例 ,颈淋巴结活检 32例。结果 甲状腺微小癌 11例。颈淋巴结转移率 65 .91% (5 8/88) ,甲状腺残癌率 31.5 9% (12 /38)。结论 颈淋巴结清扫术在甲状腺癌再次手术中具有明确的治疗作用。对侵及包膜、颈淋巴结肿大以及甲状腺微小癌应作颈淋巴结清扫术。对复发癌应再次手术。再手术需彻底切除癌灶 ,保护甲状旁腺及喉返神经
Objective To investigate the value of cervical lymphadenectomy in the reoperation of differentiated thyroid cancer and to choose the surgical procedure for reoperation of thyroid cancer. Methods A retrospective analysis of 88 cases of differentiated thyroid cancer re-operation in patients with 88 cases of cervical lymph node dissection clinical data. In 88 cases, thyroid tumor resection in 38 cases, thyroid gland plus isthmus resection in 16 cases, total thyroidectomy in 2 cases, cervical lymph node biopsy in 32 cases. Results Thyroid cancer in 11 cases. Cervical lymph node metastasis rate was 65.91% (58/88), thyroid cancer rate was 31.5% (12/38). Conclusion The cervical lymph node dissection has a clear therapeutic effect in the reoperation of thyroid cancer. On the invasion and the capsule, cervical lymph nodes and thyroid cancer should be made for cervical lymph node dissection. Recurrence of cancer surgery should be reopened. Reoperation should be completely removed the foci to protect the parathyroid and recurrent laryngeal nerve