Evaluación diagnóstica, estratificación de riesgos y estrategias de manejo perioperatorio en trastornos tiroideos
Oskar Patryk Gąsiorowski1, Joanna Kaszczewska1, Julia Tarnowska1
1DEPARTMENT OF GENERAL, VASCULAR, ENDOCRINE AND TRANSPLANT SURGERY, MEDICAL UNIVERSITY OF WARSAW, WARSAW, POLAND.
Wiadomosci lekarskie (Warsaw, Poland : 1960)
|February 1, 2026
Resumen
Esta revisión describe cuándo realizar una cirugía tiroidea electiva y las mejores estrategias para el manejo de pacientes antes y después del procedimiento. El manejo óptimo de los nódulos se ve desafiado por el acceso limitado a diagnósticos avanzados.
Área de la Ciencia:
- Endocrinología
- Oncología Quirúrgica
- Diagnóstico por Imagen
Sus antecedentes:
- Los trastornos tiroideos, incluidas la enfermedad de Graves y diversas formas de hipertiroidismo e hipotiroidismo, requieren estrategias de manejo cuidadosas.
- La intervención quirúrgica para afecciones tiroideas está indicada para nódulos sintomáticos, resultados de citología indeterminada o maligna (Bethesda III-VI) y síntomas compresivos.
Objetivo del estudio:
- Delinear las indicaciones para la cirugía tiroidea electiva.
- Definir estrategias clínicas perioperatorias para pacientes con enfermedades tiroideas.
Principales métodos:
- Se realizó una revisión exhaustiva de la literatura de publicaciones de junio de 2005 a enero de 2024.
- Las bases de datos consultadas incluyeron PubMed, Scopus, Web of Science y la Cochrane Library.
- La evaluación incluyó la citología por aspiración con aguja fina (FAN) guiada por ecografía y la estratificación de riesgos EU-TIRADS, complementada con pruebas moleculares para citología indeterminada.
Principales resultados:
- Las indicaciones clave para la tiroidectomía incluyen nódulos sintomáticos, citología indeterminada/maligna y síntomas compresivos.
- Las estrategias de manejo abordan posibles complicaciones como hemorragia, hipoparatiroidismo y lesión del nervio laríngeo recurrente.
- El seguimiento postoperatorio es crucial para la hipocalcemia, los cambios en la voz y el sangrado.
Conclusiones:
- La adopción generalizada de diagnósticos tiroideos avanzados está limitada por restricciones de recursos.
- Estas limitaciones plantean desafíos para lograr un manejo óptimo de los nódulos tiroideos.
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