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재발된 유두 갑상선암으로 완결갑상선절제술을 시행한 환자의 임상양상 및 수술합병증
김창우,이소희,유행랑,이강영,강상욱,정종주,남기현,장항석,정웅윤,박정수,Chang Woo Kim,So Hee Lee,Haeng Rang Ryu,Kang Young Rhee,Sang-Wook Kang,Jong Joo Jung,Kee-Hyun Nam,Hang Seok Chang,Woong Youn Chung,and Cheong Soo Park 대한갑상선-내분비외과학회 2009 The Koreran journal of Endocrine Surgery Vol.9 No.3
중앙 경부 재발 유두 갑상선암으로 수술한 환자의 재발 양상과 수술 합병증
윤지섭(Ji-Sup Yun),이용상(Yong Sang Lee),정종주(Jong Joo Jung),남기현(Kee-Hyun Nam),정웅윤(Woong Youn Chung),박정수(Cheong Soo Park) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.1
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.