지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2008.1
- 수록면
- 42 - 47 (6page)
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Purpose: Central compartment reoperation for recurrent thyroid carcinoma is challenging to surgeons due to the scar tissues and adhesions and the distortion of the normal anatomic relationships. This study was carried out to investigate the central neck recurrence patterns and the surgical morbidity of reoperation for patients with papillary thyroid carcinoma.
Methods: The study population was comprised 68 papillary thyroid carcinoma patients (15 males and 53 females, median age: 50.8 years [range: 12∼78 years]) who underwent reoperation for recurrent tumors in the central compartment of the neck between January 1999 and June 2007. All of the patients had undergone prior total thyroidectomy.
Results: Of the 68 patients, 21 recurrences occurred in the proper thyroid tissue of the thyroid bed, 43 in the central neck nodes and 4 in a combination of the central nodes and proper thyroid tissue. The common recurrent site from the proper thyroid tissue were at the berry ligaments and at the level of the upper one-third of the recurrent laryngeal nerves, while the common nodal recurrence sites were the lower-most portion of the paratracheal nodes and the right paraesophageal nodes (the lymph nodes posterior to the right recurrent laryngeal nerve). Eleven cases of transient hypocalcemia (17.5%, 11/63) and 3 cases of permanent hypocalcemia (4.3%, 3/63) were noted after reoperation. Recurrent laryngeal nerve injury occurred in 5 patients (8.1%, 5/62), but three of them were intentionally resected with the recurrent cancers.
Conclusion: Reoperation for central neck recurrence of papillary thyroid carcinoma is associated with a higher complication rate. Meticulous surgical dissection of the central compartment based on the recurrent patterns is important to reduce injury to the recurrent laryngeal nerves and parathyroid glands.
Methods: The study population was comprised 68 papillary thyroid carcinoma patients (15 males and 53 females, median age: 50.8 years [range: 12∼78 years]) who underwent reoperation for recurrent tumors in the central compartment of the neck between January 1999 and June 2007. All of the patients had undergone prior total thyroidectomy.
Results: Of the 68 patients, 21 recurrences occurred in the proper thyroid tissue of the thyroid bed, 43 in the central neck nodes and 4 in a combination of the central nodes and proper thyroid tissue. The common recurrent site from the proper thyroid tissue were at the berry ligaments and at the level of the upper one-third of the recurrent laryngeal nerves, while the common nodal recurrence sites were the lower-most portion of the paratracheal nodes and the right paraesophageal nodes (the lymph nodes posterior to the right recurrent laryngeal nerve). Eleven cases of transient hypocalcemia (17.5%, 11/63) and 3 cases of permanent hypocalcemia (4.3%, 3/63) were noted after reoperation. Recurrent laryngeal nerve injury occurred in 5 patients (8.1%, 5/62), but three of them were intentionally resected with the recurrent cancers.
Conclusion: Reoperation for central neck recurrence of papillary thyroid carcinoma is associated with a higher complication rate. Meticulous surgical dissection of the central compartment based on the recurrent patterns is important to reduce injury to the recurrent laryngeal nerves and parathyroid glands.
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REFERENCES
참고문헌 (29)
참고문헌 신청
1. [학술지(정기간행물)] - Mazzaferri EL / 2001 / Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer / J Clin Endocrinol Metab 86 : 1447 ~ 1463
2. [학술지(정기간행물)] - Samaan NA / 1992 / The results of various modalities of treatment of well differentiated thyroid carcinomas: retrospective review of 1599 patients / J Clin Endocrinol Metab 75 : 714 ~ 720
3. [학술지(정기간행물)] - Degroot LJ / 1990 / Natural history, treatment, and course of papillary thyroid carcinoma / J Clin Endocrinol Metab 71 : 414 ~ 424
4. [학술지(정기간행물)] - Mazzaferri EL / 1994 / Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer / Am J Med 97 : 418 ~ 428
5. [학술지(정기간행물)] - Kouvaraki MA / 2004 / Preventable reoperations for persistent and recurrent papillary thyroid carcinoma / Surgery 136 : 1183 ~ 1191
2. [학술지(정기간행물)] - Samaan NA / 1992 / The results of various modalities of treatment of well differentiated thyroid carcinomas: retrospective review of 1599 patients / J Clin Endocrinol Metab 75 : 714 ~ 720
3. [학술지(정기간행물)] - Degroot LJ / 1990 / Natural history, treatment, and course of papillary thyroid carcinoma / J Clin Endocrinol Metab 71 : 414 ~ 424
4. [학술지(정기간행물)] - Mazzaferri EL / 1994 / Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer / Am J Med 97 : 418 ~ 428
5. [학술지(정기간행물)] - Kouvaraki MA / 2004 / Preventable reoperations for persistent and recurrent papillary thyroid carcinoma / Surgery 136 : 1183 ~ 1191
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