在社区中过度治疗乳头甲状腺小瘤
Peter J Abraham1, Christopher Wu1, Rongzhi Wang1
1University of Alabama at Birmingham, Department of General Surgery, Birmingham, AL, USA.
American journal of surgery
|March 10, 2024
概括
我们社区的乳头甲状腺微瘤 (PTMC) 治疗在很大程度上有利于全甲状腺切除术,尽管与带切除术相比,神经损伤和低血症等并发症风险更高.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 甲状腺癌研究研究
背景情况:
- 乳头甲状腺癌 (PTC) 传统上是用全甲状腺切除术治疗的.
- 新出现的证据支持对低风险瘤的保守管理,例如乳头甲状腺小癌 (PTMCs).
- 这项研究调查了特定社区当前的PTMC治疗趋势.
研究的目的:
- 分析采用保守管理与PTMCs传统的全甲状腺切除术相比.
- 在社区环境中评估治疗策略和相关结果.
- 确定影响PTMC外科手术方法的因素.
主要方法:
- 从一个1433名患者的机构数据库中对258例PTMC病例进行了回顾性分析.
- 评估结果,包括死亡率,重复手术,低血症和重复性喉神经损伤 (RLN).
- 对PTMCs的全甲状腺切除术和带切除术之间的并发症率的比较.
主要成果:
- 在63.4%的PTMC患者中,进行了全甲状腺切除术.
- 整体甲状腺切除术与皮切除术相比,与显著更高的RLN损伤率 (8.8%vs2.3%) 和低血症 (12.4%vs0.0%) 相关.
- 非内分泌外科医生显示,术后放射性的使用率更高.
结论:
- 社区主要使用全甲状腺切除术用于PTMC,这与不断发展的最佳实践相反.
- 更高的并发症率强调了需要提高认识和遵守保守的PTMC指南的必要性.
- 建议进一步教育和实施指南,以优化PTMC患者护理.
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