20xx年醫(yī)學(xué)專題—分化型甲狀腺癌--姚-峰--孫圣榮實(shí)習(xí)-資料下載頁
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【正文】 ical lymphadenopathy. 活檢(hu243。 jiǎn)證實(shí)為頸側(cè)淋巴結(jié)轉(zhuǎn)移的病例應(yīng)行治療性頸側(cè)淋巴結(jié)清掃術(shù),第四十四頁，共五十三頁。,Lateral Neck Dissection(1),術(shù)前超聲檢查(jiǎnch225。)頸側(cè)方淋巴結(jié)陽性者無淋巴結(jié)復(fù)發(fā)生存率低于超聲下淋巴結(jié)陰性者,Ito Y, et al. World J. Surg. 2004； 28：498–501,第四十五頁，共五十三頁。,Lateral Neck Dissection(1),Ito Y, et al. World J. Surg. 2004； 28：498–501,術(shù)前超聲檢查頸側(cè)方淋巴結(jié)陰性者，頸側(cè)清對無淋巴結(jié)復(fù)發(fā)(f249。 fā)生存率沒有影響,第四十六頁，共五十三頁。,While most now agree that prophylactic lymph node dissections (LND) play no role, at the University of California, San Francisco (UCSF) we limit LND selectively on a level by level basis, and resect only the levels thought to harbor disease or to be at increased risk of metastases. This initial ,selective LND usually includes levels III and IV (due to the welldocumented increased likelihood of metastases to these levels) and levels I, II, and V are included when there is clinical or radiological evidence of disease or increased risk of it,Lateral Neck Dissection(2),Caron NR., et al. World J. Surg. 2006； 30：833–840,第四十七頁，共五十三頁。,Lateral Neck Dissection(2),Caron NR., et al. World J. Surg. 2006； 30：833–840,A total of 140 initial lateral LND were performed: 104 ipsilateral and 36 contralateral.,第四十八頁，共五十三頁。,Lateral Neck Dissection(2),Caron NR., et al. World J. Surg. 2006； 30：833–840,第四十九頁，共五十三頁。,Lateral Neck Dissection(2),Caron NR., et al. World J. Surg. 2006； 30：833–840,第五十頁，共五十三頁。,未 來,The Challenge of Managing Differentiated Thyroid Carcinoma Managing differentiated (i.e., papillary, follicular, and H252。rthle) thyroid carcinoma can be a challenge. Results from ongoing randomized trials will not be available for many years.,Ⅳ,第五十一頁，共五十三頁。,謝 謝,第五十二頁，共五十三頁。,內(nèi)容(n232。ir243。ng)總結(jié),分化型甲狀腺癌的手術(shù)治療 ——甲狀腺癌指南解讀。合適的手術(shù)方案是影響預(yù)后最重要的因素，碘13TSH抑制及外放療只起輔助作用。只有三種甲狀腺手術(shù)方式：患側(cè)腺葉切除、甲狀腺全切或近全切。用放射性碘行殘余腺葉消融治療被作為甲狀腺全切除術(shù)的一種替代選擇，這種方法是否可取得(qǔd233。)相似的長期效果尚不清楚。對于臨床中央組及頸側(cè)方淋巴結(jié)受累者應(yīng)該行甲狀腺全切除聯(lián)合治療性中央組淋巴結(jié)清掃術(shù)。Ⅳ,第五十三頁，共五十
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