반회후두신경을 침윤한 갑상선 유두상암에 대한 처치

• 영문명: Management of Thyroid Papillary Carcinoma Invading the Recurrent Laryngeal Nerve
• 발행기관: 대한내분비외과학회
• 저자명: 김충영 노혜원 조진성 박민호 윤정한 제갈영종 Choong Young Kim M.D. Hye Won Ro M.D. Jin Seong Cho M.D. Min Ho Park M.D. Jung Han Yoon M.D. and Young Jong Jegal M.D.
• 간행물 정보: 『The Koreran journal of Endocrine Surgery』8권2호, 95~100쪽, 전체 6쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2008.06.30

영문 초록

Purpose: Invasion of the recurrent laryngeal nerve (RLN) by papillary carcinoma of the thyroid gland is rather infrequent. Tumor excision for this patients with invasion of the RLN has been categorized into two groups on the basis of completeness: (1) Resection of the RLN was required for complete excision, and (2) isolation of the RLN from thyroid cancer was mainly performed by sharp dissection to leave as little tumor as possible. Reconstruction of the nerve after complete tumor resection can be added as a supplementary procedure. This study was designed to analyze the clinical characteristics and surgical treatment of thyroid cancer invading the RLN. Methods: At the Department of Endocrine Surgery of our hospital, 1,426 patients were diagnosed and operated on for papillary thyroid cancer during 36 months, from December 2004 to December 2006. Among them, 49 patients who revealed invasion of the recurrent laryngeal nerve were retrospectively evaluated for their age, gender, preoperative hoarseness and the operative method, change of their postoperative symptoms, radioiodine ablation, the laryngoscopic findings, recurrence and the prognosis. Results: Of the 49 patients, 10 patients had preoperative hoarseness and 13 patients were treated by complete resection. We tried reconstruction of the recurrent laryngeal nerve with using the hypoglossi-recurrent nerve in one case, and with direct end-to-end anastomosis in two cases. The rest of the 36 patients were treated by shaving resection of thyroid and leaving the RLN intact. Conclusion: When a surgeon finds papillary carcinoma infiltrating a recurrent laryngeal nerve, regardless of the preoperative symptoms, preservation of the RLN and removal of as much tumor as possible will offer a good result.. (Korean J Endocrine Surg 2008;8:95-100)

키워드

반회후두신경, 갑상선 유두상암, 신경 보존술,Recurrent laryngeal nerve, Thyroid papillary cancer, Nerve preservation