摘要
目的 :探讨保留颈丛感觉神经的功能性颈清扫术在分化性甲状腺癌上的应用。方法 :15例甲状腺乳头状癌患者 ,施行保留颈丛感觉神经的功能性颈清扫术。结果 :颈部阳性淋巴结主要分布在Ⅲ区 ,Ⅳ区 ,Ⅵ区。Ⅵ区淋巴结阳性者颈部淋巴结转移率为 (5 7 1% )。 15例患者术后全部耳部感觉良好 ,下颈部及肩部无麻木感。结论 :手术适应征 :①N0 的甲状腺乳头状腺癌。②N1的甲状腺乳头状腺癌 ,淋巴结转移仅仅局限Ⅵ区者 ,或颈内静脉旁淋巴结较小 (N <3cm)无包膜外侵犯者。手术禁忌征 :①手术前已有不规范颈清扫术史者 ;②颈淋巴结广泛转移或淋巴结有明显外侵者。
Purpose:To discuss the functional neck dissection preserving cervical plexus in the treatment of differentiated thyroid cancer.Methods:15 cases of papillary thyroid cancer underwent functional neck dissection while preserving the cervical plexus. Results:Localization of positive lymph nodes were Ⅲ, Ⅳ, Ⅵ. The rate of neck node involvement of Ⅵ (+) is 57. 1%. No impairment of sensation of ears and lower necks and upper shoulders were found in the 15 patients. Conclusions:Indications:1.N 0 patients with papillary thyroid cancers. 2.N+ patients with papillary thyroid cancers whose metastatic lymph nodes are limited to level Ⅳ, or lymph nodes of parajugular are small (<3cm)without extracapsular spread. Contraindications: 1.Patients with a history of prior neck surgery.2.Patients with massive adenopathy or gross extracapsular spread.
出处
《中国癌症杂志》
CAS
CSCD
2001年第4期361-363,366,共4页
China Oncology
