论文部分内容阅读
由于甲状腺癌的病理类型繁多,各型癌瘤的生物学特性不同,临床表现和预后差异很大。因此在治疗上一直存在分岐。目前当然不可能提出统一的术式,但应该提出一个外科治疗的基本要求。即完全切除肿瘤,减少复发率而又保留甲状旁腺和喉返神经的功能。欲达到此目的,必须从下列几个方面进行探讨。一、甲状腺癌外科处理的原则1.原发病灶的处理:对限于一叶的甲癌,患侧叶金切加峡部切除,已被公认为安全、有效的术式。累及双侧叶癌瘤可行甲状腺全切除或近全切除。保留对侧叶后包膜及少许甲状腺组织对甲状旁腺的安全有利。Harold的经验证明一叶切除与全甲状腺切除的存活率并无差别,故对一叶病灶不主张做全甲状腺切除术。切开活检、局部切除或挖
Due to the numerous pathological types of thyroid cancer, the biological characteristics of various types of cancers are different, and the clinical manifestations and prognosis are very different. Therefore, there is always a childbirth in treatment. Of course, it is impossible to propose a unified surgical procedure, but the basic requirements for surgical treatment should be proposed. That is to completely remove the tumor, reduce the recurrence rate and retain the function of the parathyroid gland and recurrent laryngeal nerve. To achieve this goal, we must discuss the following aspects. First, the principle of surgical treatment of thyroid cancer 1. The treatment of the primary lesion: For the limited to a leaf of the cancer, ipsilateral leaf gold cut plus isthmic resection, has been recognized as safe and effective surgical procedures. Involve bilateral bilateral carcinomas with viable thyroidectomy or near total resection. Keeping the posterior capsule of the lateral lobe and a few thyroid glands is safe for parathyroid glands. Harold’s experience shows that there is no difference in the survival rate between lobectomy and total thyroidectomy. Therefore, it is not advisable to perform a total thyroidectomy on a leaf lesion. Cut biopsy, local resection or dig