分化型甲状腺癌侵犯喉返神经的外科处理  

Surgical treatment for differentiated thyroid carcinoma with recurrent laryngeal nerve invaded

作　　者：吴文澜[1] 王玥[1] 

机构地区：[1]江苏省肿瘤医院头颈外科,江苏南京210009

出　　处：《中国肿瘤外科杂志》2011年第4期211-213,共3页Chinese Journal of Surgical Oncology

摘　　要：目的探讨受分化型甲状腺癌侵犯的喉返神经的外科处理方法。方法回顾性分析江苏省肿瘤医院头颈外科2006—2008年经治的19例分化型甲状腺癌中喉返神经受侵犯患者的术前诊断、手术方法及预后。结果 19例均成功施行甲状腺癌根治术,其中15例采用剥离法保留了喉返神经,另4例因喉返神经受侵严重无法分离而被切除。喉返神经切除4例中3例行端端吻合。所有病例术后均获随访6个月～2年,无1例死亡。1例于术后6个月因对侧颈部淋巴结转移而再次手术。结论甲状腺癌侵犯喉返神经时切勿盲目切除喉返神经,为保留患者声带功能,应尽量采用合适的手术方法予以保留。Objective To study the surgical approach of differentiated thyroid carcinoma with recurrent laryngeal nerve invaded. Methods A total of 19 patients with differentiated thyroid carcinoma from 2006 to 2008 treated in this hospital were retrospectively reviewed. We analyzed their diagnosis, surgical technique and prognosis. Results All of the patients were treated by radical resection. The recurrent laryngeal nerves were separated and preserved successfully in 15 cases, and the nerves in rest cases were resected, End-to-end anastomosis were performed in 3 cases. The follow up of all patients ranged from 6 months to 2 years, no died. Only 1 patient were operated again because of the lymph node metastasis of opposite side. Conclusions We can preserve the recurrent laryngeal nerve even if it is invaded in patients with differentiated thyroid carcinoma with appropriate methods.

关 键 词：分化型甲状腺癌 甲状腺癌根治术 声带麻痹 喉返神经 

分 类 号：R736.1[医药卫生—肿瘤]