针对差异化甲状腺癌的最初与分阶段甲状腺切除术:对有效性和安全性的回顾性多维队列分析
Eman A Toraih1,2, Mohammad H Hussein1, Jessan A Jishu3
1Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA.
Cancers
|June 27, 2024
概括
对于差异化甲状腺癌,前期全甲状腺切除术与阶段性完成甲状腺切除术相比,增加了低血症的风险. 最佳完成甲状腺切除术的时间在切除术后1-6个月之间,可以减少永久性并发症.
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:
- 差异化甲状腺癌的外科治疗涉及前期全甲状腺切除术与分阶段完成甲状腺切除术的辩论.
- 进行甲状腺切除术的比较风险和最佳时间需要进一步调查.
研究的目的:
- 评估前期全甲状腺切除术与分化甲状腺癌阶段性完成甲状腺切除术的并发症率.
- 确定完成甲状腺切除术的最佳时间,以尽量减少并发症.
主要方法:
- 四个队列的多维分析:机构序列 (n=148),NSQIP数据库 (n=39,992),TrinetX存储库 (n>30,000) 和综合文献评论 (10项研究,n=6015).
- 包括元分析在内的统计分析,以比较并发症率和风险因素.
主要成果:
- 整体甲状腺切除显示出更高的整体并发症率,特别是暂时的低血症 (机构数据中10%vs0%).
- NSQIP和元分析证实,全甲状腺切除术增加了暂时 (72%,RR=1.63) 和永久 (25%,RR=1.23) 低血症的风险.
- 完成甲状腺切除术后1至6个月的甲状腺切除术与延迟>6个月相比,与较低的永久并发症率有关.
结论:
- 针对差异化甲状腺癌的前期全甲状腺切除术与过渡性和永久性低血症的风险增加有关.
- 逐步完成的甲状腺切除术,特别是在1-6个月内,可能提供一种更安全的方法,减少永久性并发症风险.
- 研究结果支持对差异化甲状腺癌患者进行个性化手术决策.
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