经胸经口联合入路腔镜甲状腺癌V区淋巴结清扫的探索  

Endoscopic level V lymph node dissection via breast combined with oral approach for papillary thyroid cancer

作　　者：王源源 罗晔哲[2] 吴国洋[2] 严朝龙 李宏[3] Yuanyuan Wang;Yezhe Luo;Guoyang Wu;Chaolong Yan;Hong Li(The Second Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of General Surgery,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 361000,China;Department of Tumor Surgery,General Hospital of Ningxia Medical University,Ningxia 750000,China)

机构地区：[1]郑州大学第一附属医院甲状腺外二科,郑州450000 [2]厦门大学附属中山医院普外科,厦门361000 [3]宁夏医科大学总医院肿瘤外科,宁夏750000

出　　处：《中华内分泌外科杂志》2022年第5期565-567,共3页Chinese Journal of Endocrine Surgery

摘　　要：目的探讨腔镜甲状腺癌手术颈部V区淋巴结清扫的安全性及可行性。方法回顾性分析2021年5月至9月在宁夏医科大学总医院肿瘤外科和厦门大学附属中山医院普外科收治的2例行经胸经口联合入路腔镜甲状腺切除和中央区及颈侧区淋巴结清扫的甲状腺乳头状癌患者的资料。两例均为女性患者。术前甲状腺原发灶及转移淋巴结均经细针穿刺病理确诊,术前完善彩超、CT及喉镜等检查。结果两例手术均在腔镜下顺利完成,例1颈部V区检出1枚淋巴结,未见转移淋巴结。例2颈部V区检出7枚淋巴结,两例术后均未出现肩部功能障碍。结论两例腔镜甲状腺癌手术颈部V区淋巴结清扫是安全并可行的,后续需增加病例数量后进一步分析,并逐渐推广此术式。Objective To investigate the safety and feasibility of endoscopic level V lymph node dissection for thyroid cancer.Methods Two cases undergoing level V lymph node dissection via breast combined with oral approach for papillary thyroid cancer in May.2021 and Sep.2021 were retrospectively analyzed.The primary thyroid lesions and metastatic lymph nodes were diagnosed pathologically by fine needle aspiration before operation.The routine examination such as ultrasound,CT and laryngoscopy were completed before operation.Results Both operations were successfully completed under endoscopy.In case 1,one lymph node was found in neck V region,and no metastatic lymph node was found.In case 2,7 lymph nodes were found in cervical V region.No"shoulder syndrome"encompassing shoulder dysfunction and pain was found in either case.Conclusions The study on the two cases reveals that level V dissection after the routine operation of endoscopic central and lateral neck dissection via breast combined with oral approach for papillary thyroid cancer is feasible and safe.More cases in further study were needed for to verify the finding.

关 键 词：甲状腺癌 腔镜 颈侧区淋巴结清扫 

分 类 号：R736.1[医药卫生—肿瘤]