甲状腺乳头状癌热消融治疗后再手术11例分析  

Clinical analysis of ultrasound-guided thermal ablation in initial treatment of papillary thyroid cancer: report of eleven cases of reoperation

作　　者：刘新承 郝少龙[1] 陈焕杰 吴国长[1] 宁进尧[1] 郑海涛[1] Liu Xinchen;Hao Shaolong;Chen Huanfie;WuGuochang;NingJinyao;Zheng Haitao(Department of Thyroid Surgery,Yuhuangding Hospital Affiliated to Qingdao University,Shandong 264000,Chin)

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院甲状腺外科,264000

出　　处：《中华普外科手术学杂志（电子版）》2018年第4期299-301,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：山东省自然科学基金资助项目(ZR2015HL092)~~

摘　　要：目的总结可手术甲状腺癌热消融后再手术的治疗体会。方法回顾性分析了2014年2月至2015年7月期间,热消融治疗同时穿刺后病理为甲状腺乳头状癌的再手术患者11例资料。单侧腺叶加峡部切除8例,全甲切除3例,都行中央区淋巴结清扫,其中1例行同侧择区颈淋巴结清扫术。结果中央区淋巴结未转移3例,转移患者8例,占72.73%(8/11)。消融侧甲状腺组织有残留乳头状癌病灶2例(2/11,18.18%)。11例患者全部得到随访,平均3~18个月,平均7.8个月,所有患者未再复发和转移。结论可手术的甲状腺癌不宜行消融治疗。热消融达不到肿瘤根治的效果,甲状腺结节消融治疗需要严格规范,再次手术可取得较好的预后。Objective To summarize treatment experience of patients who underwent reo-peration after thermal ablation. Methods From February 2014 to July 2015, clinical data of 11 patients with papillary thyroid carcinoma who underwent initial thermal ablation and reoperation were analyzed retrospectively. All patients underwent CLN, including resection of unilateral lobe with isthmus in 8 patients and total thyroidectomy in 3 patients, furthermore a patient received ipsilateral selection area lymphadenectomy. Method In the present retrospective study, 8 patients＇ CLN were negative （72.73%）. Also, residual papillary cancer tissues were found in 2 patients after ablating （18.18%）. All patients were successfully followed up, with an average time of 7.8 months （3 - 18 months）. No recurrence and metastasis. Conclusion Ablation therapy is not suitable for patients who meet the indications of surgery. Thermal ablation is not a radical cure for cancer. Thermal a-blation should be strictly regulated in order to guide the surgeon to determine the most appropriate surgical strategy for each patient. The present study shows reoperation may improve the prognosis.

关 键 词：甲状腺肿瘤 癌 乳头状 高温 诱发 

分 类 号：R736.1[医药卫生—肿瘤]