甲状腺癌联合根治术  

Radical resection of thyroid carcinoma

作　　者：李振东[1] 

机构地区：[1]辽宁省肿瘤医院头颈外科,沈阳110042

出　　处：《中华普外科手术学杂志（电子版）》2015年第6期19-19,共1页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：左甲状腺癌联合根治,右甲状腺叶切除术左颈L型切口,颈阔肌下游离皮瓣,分离胸锁乳突肌前缘,打开颈动脉鞘,离断甲状腺中、下静脉,保护好颈内静脉、颈总动脉、迷走神经,离断甲状腺上动脉,保护喉返神经与甲状旁腺后在气管表面切除左叶甲状腺及峡部。清除左颈Ⅵ区及气管前淋巴结,清扫左颈侧区淋巴组织、脂肪组织及结缔组织,范围上自下颌骨下缘,下至锁骨,前自带状肌侧缘,后至斜方肌前缘,颈深筋膜深层。清扫左颈Ⅱ区、Ⅲ区、Ⅳ区、Ⅴ区淋巴结,保护好舌下神经、副神经、臂丛神经、膈神经,切除右叶甲状腺及其内肿物。Left side combined radical resection of thyroid carcinoma and right side thyroidectomy were performed by using left cervical L incision. Firstly,the skin flap is separated under the platysma while isolating the sternocleidomastoideus muscle and dissecting the sheath of the carotid artery. Then the veins of the thyroid gland are cut off and ligated. The jugular vein,carotid artery and vagus nerve should be preserved. The superior thyroid artery should be severed and ligated. After protection of the recurrent laryngeal nerve and parathyroid gland,and the left thyroid lobe on the surface of the trachea is cut off,and the lymph nodes of VI region are dissected. The lymph nodes,adipose tissue and connective tissue of the left side on the neck are dissected subsequently. The upper bound is the inferior border of mandibles,and the the lower bound is the clavicle. The front bound is ribbon muscle. The posterior bound is the musculi trapezius. The deep bound is the anterior cone fascia. The lymph nodes in regions II,III,IV,and V are dissected while preserving the hypoglossal nerve,accessory nerve,brachial nerve and phrenicus nerve. At last,the right thyroid is removed.

关 键 词：甲状腺肿瘤 甲状腺切除术 颈淋巴结清扫术 

分 类 号：R736.1[医药卫生—肿瘤]