根据2014年美国甲状腺协会关于甲状腺癌的指南,临床实践的变化:来自第三级推中心的回顾性研究
Federico Cappellacci1, Gian Luigi Canu1, Eleonora Noli1
1Department of Surgical Sciences, University of Cagliari, "Policlinico Universitario Duilio Casula", 09042 Cagliari, Italy.
Journal of personalized medicine
|July 27, 2024
概括
甲状腺切除术的实践正在转向更少的侵入性叶片切除术,与美国甲状腺协会的指导方针保持一致. 这一趋势表明,保守性手术对于选择的甲状腺疾病是有效的,而不会影响患者的结果.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 甲状腺学 甲状腺学
背景情况:
- 2014年美国甲状腺协会 (ATA) 的指导方针建议在特定的甲状腺疾病中采取保守的外科手术方法,比如分叶切除术.
- 甲状腺切除术的指示已经发展,强调了量身定制的手术策略.
研究的目的:
- 在2014-2023年期间,分析甲状腺切除术的趋势 (小肠切除术与全甲状腺切除术).
- 根据ATA指导方针,评估符合带切除术条件的患者的瘤结局.
主要方法:
- 在2014年1月至2023年12月期间,对357名接受甲状腺切除术的患者进行了回顾性分析.
- 纳入标准:瘤<4厘米,不确定的结节,或与临床不涉及淋巴结 (cN0) 的差异化甲状腺癌.
- 带切除术与全甲状腺切除术 (TT) 率和瘤结局的比较.
主要成果:
- 腰椎切除术的患病率显著增加,到2023年达到73.9%.
- 全甲状腺切除术 (TT) 在女性患者和患有自身免疫性甲状腺炎或恶性瘤的患者中更为常见.
- 虽然TT显示了更高的淋巴结转移率,但在恶性病例中,TT和带切除术之间的复发率相似.
结论:
- 一个显著的转向叶切除术的转变反映了对ATA指南的遵守.
- 保守的甲状腺手术,如叶切除术,似乎是可行的和安全的选择患者.
- 需要进一步的研究来完善患者选择和评估长期结果.
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