[Use of en bloc principle in re-operation of thyroid carcinoma].
OBJECTIVE
The study is to explore the extent, main-point and use of en bloc principle in re-operation of thyroid carcinoma.


METHODS
Clinical data of 75 patients received re-operation from 2002 to 2006 because of nonstandard operation were reviewed, including 10 men, 65 women, age ranging from 21-56. Ipsilateral completing lobectomy, isthmectomy, ipsilateral anterior cervical muscle, and level VI dissection were done in all the patients by en bloc principle.


RESULTS
Residual tumor was found in 39 cases. There were, 10 in primary site, 8 in VI level, and 21 in both. Therefore tumor residual rate was 52.0%. The total metastatic lymph nodes in VI level were 63. Among the eight patients with recurrent laryngeal nerves paralyses which were hurt in the first operation, 4 were found been cut completely, 4 were ligated. The ligated locations were all near the place which the nerve enter the larynx. The ligated nerves were released, and the patients voice was improved greatly.


CONCLUSIONS
Ipsilateral completing lobectomy, isthmectomy, ipsilateral anterior cervical muscle and VI level dissection is adequate for thyroid carcinoma patients who received nonstandard operation. The principle of en bloc resection can be used in the reoperation of thyroid carcinoma.
Yu
Wen-bin
WB
Department of Head and Neck Surgery, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research Ministry of Education, Beijing 100036, China. yuwenbin429@yahoo.com
Zhang
Nai-song
NS
Zeng
Zong-yuan
ZY
D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000601:surgery; D012086:Reoperation; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D055815:Young Adult