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本文对我院1961年1月～1981年12月21年间收治的203例计209例次分化型甲状腺癌行功能性颈淋巴结清除术进行了回顾分析。其中预防性清除术153例次,侵出包膜者102例次。治疗性清除术56例次侵出包膜者31例次。预防性组三保留(保留胸锁乳突肌、颈内静脉及副神经)手术率占34%,而治疗性组三保留手术率仅占14.3%。可见预防性清除术不但根治彻底而且功能保留率较治疗性组高出一倍多。作者提出:分化型甲状腺癌患者多为年轻女性,颈淋巴结转移率高,对腺内型及腺外型甲状腺乳头状腺癌,建议行三保留的功能性淋巴结清除术。此种手术与传统的颈淋巴结清除术相比合并症少,术后功能良好,外观美,预后亦佳。
This article retrospectively analyzed the functional cervical lymph node dissection of 203 cases of subdifferentiated thyroid cancer treated in our hospital from January 1961 to December 1981. Among them, 153 cases were performed with preventive removal and 102 cases were invaded. Therapeutic clearance was performed in 56 cases of invasive capsules in 31 cases. The preventive group III retention (retaining the sternocleidomastoid muscle, internal jugular vein, and accessory nerves) was 34%, while the therapeutic group III retained only 14.3%. It can be seen that the preventive debridement is not only radical and the functional retention rate is more than double that of the therapeutic group. The authors propose that the patients with differentiated thyroid cancer are mostly young women with a high rate of cervical lymph node metastasis. For intra- and extra-adenotype thyroid papillary adenocarcinomas, it is recommended to perform three-reserve functional lymphadenectomy. This type of surgery has fewer complications than conventional cervical lymph node dissection. It has good postoperative function, a beautiful appearance, and a good prognosis.