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中华普外科手术学杂志(电子版) ›› 2024, Vol. 18 ›› Issue (05) : 477 -481. doi: 10.3877/cma.j.issn.1674-3946.2024.05.002

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分化型甲状腺癌根治性切除术中的关键考量与策略
孙辉1,(), 李长霖1   
  1. 1. 130033 长春,吉林大学中日联谊医院甲状腺外科,吉林省外科转化医学重点实验室,吉林省甲状腺疾病防治工程实验室
  • 收稿日期:2024-05-05 出版日期:2024-10-26
  • 通信作者: 孙辉

Key considerations and strategies for radical resection of differentiated thyroid carcinoma

Hui Sun1,(), Changlin Li1   

  1. 1. Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Translational Medicine of Surgery, Jilin Provincial Engineering Laboratory of Thyroid Disease Prevention and Treatment, Changchun Jilin Province 130033, China
  • Received:2024-05-05 Published:2024-10-26
  • Corresponding author: Hui Sun
  • Supported by:
    This study was supported by the National Nature Science Foundation of China(82203750); the Project of Jilin Provincial Finance Department(2022SCZ38)
引用本文:

孙辉, 李长霖. 分化型甲状腺癌根治性切除术中的关键考量与策略[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 477-481.

Hui Sun, Changlin Li. Key considerations and strategies for radical resection of differentiated thyroid carcinoma[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 477-481.

本文综述分化型甲状腺癌(DTC)根治性切除术中的关键考量与策略,涵盖从原发灶与淋巴结切除范围的确定,到术中病理评估与决策的动态调整,再到分子标志物在手术决策中的辅助应用等多个方面。此外,进一步探讨甲状腺癌的腔镜治疗选择、手术并发症的预防策略、甲状腺功能保护及替代治疗的重要性,以及术后随访与复发监测的必要性和多学科协作的综合治疗模式。通过深入分析这些关键问题,本文旨在为临床医生提供全面而精准的治疗指导,进而提升DTC患者的治疗效果和生活质量。

This article provides a comprehensive review of the key considerations and strategies involved in radical resection surgery for differentiated thyroid cancer (DTC). The scope of resection for primary lesions and lymph nodes, intraoperative pathological assessment and decision-making adjustments, and the value of molecular markers in intraoperative decision-making are all discussed. Furthermore, the review explores the options for endoscopic treatment of thyroid cancer, preventive strategies for common surgical complications, the importance of thyroid function preservation and replacement therapy, as well as the necessity of postoperative follow-up and recurrence monitoring. The role of multidisciplinary collaboration in comprehensive treatment is also emphasized. By delving into these crucial aspects, this article aims to provide clinicians with comprehensive and precise guidance for treating DTC, ultimately aiming to improve patient outcomes and quality of life.

[1]
Haugen BRAlexander EKBible KC,et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid2016,26(1):1-133.
[2]
田文,阳泽龙. 甲状腺乳头状癌流行病学及诊疗焦点探讨[J]. 西安交通大学学报(医学版)2024,45(01):44-48.
[3]
田文,赵文新. 腔镜分化型甲状腺根治术难点与争议[J/CD]. 中华普外科手术学杂志(电子版)2018,12(06):451-454.
[4]
孙辉,李世杰,付言涛,等. 分化型甲状腺功能性或创痛性颈淋巴结清扫术的利弊[J/CD]. 中华普外科手术学杂志(电子版)2018,12(06):455-457.
[5]
Lee JPark JHLee C-R,et al. Long-term outcomes of total thyroidectomy versus thyroid lobectomy for papillary thyroid microcarcinoma: comparative analysis after propensity score matching[J]. Thyroid2013,23(11):1408-1415.
[6]
Zhang CLi YLi J,et al. Total thyroidectomy versus lobectomy for papillary thyroid cancer: A systematic review and meta-analysis[J]. Medicine(Baltimore)2020,99(6):e19073.
[7]
Wang TSSosa JA. Thyroid surgery for differentiated thyroid cancer - recent advances and future directions[J]. Nat Rev Endocrinol2018,14(11):670-683.
[8]
Kim SKPark IWoo J-W,et al. Total thyroidectomy versus lobectomy in conventional papillary thyroid microcarcinoma: Analysis of 8,676 patients at a single institution[J]. Surgery2017,161(2):485-492.
[9]
Bosset MBonjour MCastellnou S,et al. Long-Term Outcome of Lobectomy for Thyroid Cancer[J]. Eur Thyroid J2021,10(6):486-494.
[10]
Ito YOnoda NOkamoto T. The revised clinical practice guidelines on the management of thyroid tumors by the Japan Associations of Endocrine Surgeons: Core questions and recommendations for treatments of thyroid cancer[J]. Endocr J2020,67(7):669-717.
[11]
田文,王冰. 甲状腺癌根治术关键技术标准及评价[J]. 中国实用外科杂志2024,44(01):38-42.
[12]
中华医学会内分泌学分会,中华医学会外科学分会甲状腺及代谢外科学组,中国抗癌协会头颈肿瘤专业委员会,等. 甲状腺结节和分化型甲状腺癌诊治指南(第二版)[J]. 国际内分泌代谢杂志2023,43(02):149-194.
[13]
Li YChen PLi Z,et al. Rule-based automatic diagnosis of thyroid nodules from intraoperative frozen sections using deep learning[J]. Artif Intell Med2020,108:101918.
[14]
Yang PYang LDong Y,et al. Impact of intraoperative frozen section pathology on the treatment outcome of unilateral papillary thyroid microcarcinoma and its influencing factors-a retrospective cohort study[J]. Gland Surg2022,11(10):1656-1664.
[15]
Vuong CDWatson WBKwon DI,et al. Cost effectiveness of intraoperative pathology in the management of indeterminate thyroid nodules[J]. Arch Endocrinol Metab2020,64(4):356-361.
[16]
中国抗癌协会甲状腺癌专业委员会(CATO). 甲状腺癌血清标志物临床应用专家共识(2017版)[J]. 中国肿瘤临床2018,45(01):7-13.
[17]
Jang AJin MKim CA,et al. Serum thyroglobulin testing after thyroid lobectomy in patients with 1-4 cm papillary thyroid carcinoma[J]. Endocrine2023,81(2):290-297.
[18]
Giovanella LCeriani LGaro ML. Is thyroglobulin a reliable biomarker of differentiated thyroid cancer in patients treated by lobectomy?A systematic review and meta-analysis[J]. Clin Chem Lab Med2022,60(7):1091-1100.
[19]
Lee IAKim KKim JK,et al. Comparison of Surgical Outcomes between Robotic Transaxillary and Conventional Open Thyroidectomy in Pediatric Thyroid Cancer[J]. Cancers(Basel)2021,13(13):3293.
[20]
Liu ZLi YWang Y,et al. Comparison of the transoral endoscopic thyroidectomy vestibular approach and open thyroidectomy: A propensity score-matched analysis of surgical outcomes and safety in the treatment of papillary thyroid carcinoma[J]. Surgery2021,170(6):1680-1686.
[21]
王平,谢秋萍. 腔镜甲状腺手术临床应用争议和共识[J]. 中国实用外科杂志2015,35(01):76-78.
[22]
田文,刘军言. 中国甲状腺外科近十年成就[J]. 西安交通大学学报(医学版)2024,45(01):1-8.
[23]
王平,项承. 经胸前入路腔镜甲状腺手术专家共识(2017版)[J]. 中国实用外科杂志2017,37(12):1369-1373.
[24]
王平,吴国洋,田文,等. 经口腔前庭入路腔镜甲状腺手术专家共识(2018版)[J]. 中国实用外科杂志2018,38(10):1104-1107.
[25]
孙辉,田文. 中国甲状腺及甲状旁腺手术中神经监测指南(2023版)[J]. 中国实用外科杂志2023,43(01):23-33.
[26]
朱精强,田文,苏安平. 甲状腺围手术期甲状旁腺功能保护指南(2018版)[J]. 中国实用外科杂志2018,38(10):1108-1113.
[27]
田文,姚京. 围手术期甲状旁腺功能保护[J]. 中华内分泌外科杂志2024,18(01):12-16.
[28]
Barranco HFazendin JLindeman B,et al. Thyroid hormone replacement following lobectomy: Long-term institutional analysis 15 years after surgery[J]. Surgery2023,173(1):189-192.
[29]
Park JHYoon JH. Lobectomy in patients with differentiated thyroid cancer: indications and follow-up[J]. Endocr Relat Cancer2019,26(7):R381-R393.
[30]
Gray J LSingh GUttley L,et al. Routine thyroglobulin,neck ultrasound and physical examination in the routine follow up of patients with differentiated thyroid cancer-Where is the evidence?[J]. Endocrine2018,62(1):26-33.
[31]
Ju S-HJi YBSong M,et al. Feasibility of active surveillance in patients with clinically T1b papillary thyroid carcinoma ≤1.5 cm in preoperative ultrasonography: MASTER study[J]. Eur Thyroid J2024,13(2):e230258.
[32]
Eichhorn JNelson NRaichandani S,et al. Prostate-Specific Membrane Antigen PET/CT Detection of Prostate Cancer Metastasis to Thyroid and Cricoid Cartilages[J]. Clin Nucl Med2024,49(5):481-483.
[33]
Li JZhang BBai Y,et al. Health-related quality of life analysis in differentiated thyroid carcinoma patients after thyroidectomy[J]. Sci Rep2020,10(1):5765.
[34]
詹美莺,吴雪云,周玲珍. 基于多学科协作下ERAS措施在甲状腺癌手术中的价值分析[J]. 中国冶金工业医学杂志2023,40(04):417-418.
[35]
樊友本,田文,房居高,等. 局部晚期甲状腺癌手术治疗中国专家共识(2020版)[J]. 中国实用外科杂志2020,40(04):369-376.
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