Till sidans topp

Sidansvarig: Webbredaktion
Sidan uppdaterades: 2012-09-11 15:12

Tipsa en vän
Utskriftsversion

Surgical management of cy… - Göteborgs universitet Till startsida
Webbkarta
Till innehåll Läs mer om hur kakor används på gu.se

Surgical management of cytologically indeterminate thyroid nodules

Artikel i vetenskaplig tidskrift
Författare M. Almquist
Andreas Muth
Publicerad i Gland Surgery
Volym 8
Sidor S105-S111
ISSN 2227-684X
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för kirurgi
Sidor S105-S111
Språk en
Länkar dx.doi.org/10.21037/gs.2019.01.03
Ämnesord Thyroid nodule, surgery, Bethesda, review, pediatric endocrine surgery, association guidelines, outpatient, thyroidectomy, cancer, volume, outcomes, risk, diagnosis, hypoparathyroidism, complications, Surgery
Ämneskategorier Kirurgi

Sammanfattning

Nodules in the thyroid are frequent. Preoperative investigations including fine-needle cytology and ultrasound cannot in all patients rule out malignancy. Thus, surgical excision for histopathologic examination is often needed. In this narrative review, we examine aspects of the surgical management of indeterminate thyroid nodules, using a comprehensive review of the available literature. The authors manually searched PubMed for relevant literature, including recently published guidelines. Hemithyroidectomy without lymph node dissection remains the recommended management in indeterminate thyroid nodules, i.e., the complete removal of one lobe of the thyroid, for indeterminate thyroid nodules, defined as nodules with fine-needle cytology fulfilling the criteria of Bethesda III or IV categories. At surgery, it is important to preserve the recurrent and superior laryngeal nerves, and intraoperative neuromonitoring is a useful adjunct. Recent data also suggest that parathyroid autofluorescent techniques are promising tools for parathyroid preservation. There is still lack of specific preoperative investigations to rule in or out central lymph node metastasis. Intraoperative frozen section of lymph nodes can be valuable, but prophylactic or diagnostic central lymph node dissection is not routinely recommended. Outcomes after thyroid surgery arc better with high-volume surgeons and institutions. Surgery is probably best performed by high-volume surgeons in institutions with on-site expert pathologists and with technical adjuncts available for nerve and parathyroid preservation. Day-care surgery may be an option for selected patients.

Sidansvarig: Webbredaktion|Sidan uppdaterades: 2012-09-11
Dela:

På Göteborgs universitet använder vi kakor (cookies) för att webbplatsen ska fungera på ett bra sätt för dig. Genom att surfa vidare godkänner du att vi använder kakor.  Vad är kakor?