甲状腺癌发病率在全世界范围内增长迅速。大多甲状腺癌中度恶性,预后好。但有局部复发转移的可能性。由于甲状腺癌首次手术切除范围不够,带来复发和转移的危险。对济南军区总医院甲状腺乳腺外科近几年收治的甲状腺二次手术的79例患者进行回顾性研究。其中乳头状癌为主要病理类型,甲状腺相关肿瘤残留率达62.0%(49/79),淋巴结相关肿瘤残留率为53.2%(42/79)。首次手术切除范围小于一侧腺叶14例(17.7%),一侧腺叶全切6例(7.6%),甲状腺次全切30例(38.0%)。未行局部淋巴结清除的占82.3%。首次手术原发部位(同侧腺叶)肿瘤残留8例(10.1%),原发部位外腺体组织(对侧腺叶或峡部)肿瘤残留13例(16.5%),淋巴结肿瘤残留14例(17.7%),原发部位+淋巴结均有肿瘤残留28例(35.4%)。手术是甲状腺癌治疗中最为重要的手段之一,规范合理的手术方式可影响复发转移率,并影响患者生存质量。 The incidence of thyroid cancer is growing rapidly throughout the world. Most of the moderately malignant thyroid cancer, the prognosis is good. But there is the possibility of local recurrence and metastasis. Due to thyroid cancer is not the first surgical resection range, bringing the risk of recurrence and metastasis. A retrospective study was performed on 79 patients undergoing secondary thyroid surgery admitted to the thyroid gland surgery department of Jinan Military Region General Hospital in recent years. Papillary carcinoma was the main pathological type. The residual rate of thyroid-related tumors was 62.0% (49/79), and the residual rate of lymph node-associated tumors was 53.2% (42/79). The first resection was performed in 14 cases (17.7%) of the glandular lobes on one side, 6 cases (7.6%) on the one side of the gland and 30 cases (38.0%) on the subtotal thyroidectomy. No local lymph node dissection accounted for 82.3%. In the first operation, there were 8 cases (10.1%) of the residual tumor in the primary site (ipsilateral lobes), 13 (16.5%) in the primary gland or the isthmus, 14 in the remaining 17.7%), the tumor was found in 28 cases (35.4%) in the primary site + lymph node. Surgery is one of the most important methods in the treatment of thyroid cancer. Regulating a reasonable operation method can affect the recurrence and metastasis rate and affect the quality of life of patients.