若年者甲状腺分化癌手術と術後経過 DIFFERENTIATED THYROID CARCINOMA IN YOUNG PATIENTS : SURGICAL APPROACH AND POSTOPERATIVE COURSE INCLUDING THE QUALITY OF LIFE

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1979年から1992年までに,当教室では甲状腺分化癌手術を392例経験したが,このうち20歳未満の若年者は18例であった.若年者症例にも成人と同様,「(1)甲状腺全摘,(2)両側頸部郭清,(3)上皮小体自家移植」の基本術式を原則として施行してきた.腫瘍径やリンパ節転移などを成人と比較,また術後経過についてQuality of lifeを含め追跡し,当教室の術式の是非を検討した.腫瘍径はt2以上が全体の約80%を占めたが,成人は60%に留まった.またリンパ節転移は約90%の症例に認めたが,成人例は76%であった.若年者は手術時に成人より進行していたが,18例のうち1例も再発を認めていない.また術後の合併症は,軽度の上皮小体機能低下症1例と術創ケロイド3例のみであった. 10歳以下の症例の成長・発育にも何ら問題はなく,適齢期に達した女性5症例のうち3例は児を設けている.充分な根治性と良好な術後経過を期待できる,妥当な術式と考えられた.

From 1979 through 1992, we have conducted operations for differentiated thyroid carcinoma in 392 cases, 18 of which were under the age of 20. As in the case of adults, the same basic surgical approach was used for the young patients: 1) total thyroidectomy, 2) bilateral lymph node dissection, and 3) parathyroid autotransplantation. We attempted to determine the strengths and weaknesses of our operative approach by comparing for diameter of neoplasms, lymph node metastases and the like with adults, including the Quality of Life in the postoperative course. Tumor diameter was more than t2 in 80% of the cases, and in 60% of adults. Lymph node metastases were found in about 90% of the patients, and in 76% of the adults. Evidence of progressive carcinoma was found operatively in more young persons than adults, but there was no recurrence in all 18 cases. Postoperative complications included only a mildly lowered parathyroid function in one case and postoperative cheloid in 3 cases. No problem whatsover was noted in growth or development of the patients less than 10 years of age; 3 females who had come of age had children. Thus our surgical approach is considered appropriate, and promises sufficient radicality and favorable postoperative course.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 56(7), 1296-1300, 1995-07-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008514165
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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