多学科联合诊治累及颈总动脉的晚期甲状腺恶性肿瘤  

Multidisciplinary diagnosis and treatment of advanced thyroid carcinoma invading common carotid artery

作　　者：孙滨[1,2] 邓先兆[1,2] 康杰[1,2] 郭伯敏[1,2] 王宗平[1,2] 邵明哲[1] 赵珺[1] 樊友本[1,2] 

机构地区：[1]上海交通大学附属第六人民医院普外科,200233 [2]上海交通大学甲状腺疾病诊治中心

出　　处：《中华内分泌外科杂志》2017年第4期274-277,293,共5页Chinese Journal of Endocrine Surgery

基　　金：国家自然科学基金（81670718）

摘　　要：目的探讨多学科（multidisciplinary team，MDT）联合行颈总动脉切除重建术在甲状腺恶性肿瘤累及颈总动脉治疗中的应用价值。方法回顾性分析上海交通大学附属第六人民医院普外科收治的10例甲状腺恶性肿瘤侵犯颈总动脉行一期切除肿瘤和颈总动脉及颈总动脉一期重建手术资料，包括术前普外科及血管外科联合评估、术中甲状腺外科、血管外科、骨科联合手术及术后共同管理并发症。结果所有患者手术后均未出现明显神经功能障碍。1例术后出现患侧Honor综合征、1例出现声音嘶哑现象，2例术后出现伤口感染，随访期间2例肿瘤局部复发，2例出现远处转移。结论对于侵犯颈总动脉的甲状腺恶性肿瘤，MDT联合行颈总动脉切除一期重建术在降低手术并发症的同时保证了肿瘤的完整切除，具有较好的应用价值。Objective To investigate the application of carotid artery resection and reconstruction in sur- gical management of thyroid carcinoma with carotid artery involvement. Methods We conducted a retrospective cohort study involving l0 patients whose common carotid arteries were invaded by thyroid carcinoma. All patients underwent tumor en bloc resection and carotid arteries reconstruction. Patients were evaluated by multidisci- plinary team and surgeries were cooperated by general surgeons, orthopedists and vascular surgeons. The periop- erative complications and surgical outcomes were also recorded and analyzed. Results No patient had complica- tions of central nervous system. One patient suffered Homer syndrome and one presented hoarseness postopera- tive. Two patients had wound infection, two patients presented carcinoma recurrence and two patients presented distant metastasis during the follow-up. Conclusion En bloc resection of tumor and carotid artery reconstruction is a feasible modality in treatment of thyroid carcinoma with carotid artery invasion.

关 键 词：甲状腺恶性肿瘤 颈总动脉 动脉重建术 多学科联合 

分 类 号：R736.1[医药卫生—肿瘤]