Multinodular goiter: surgical management and histopathological findings
Multinodular goiter: surgical management and histopathological findings
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多结节性甲状腺肿：手术治疗和组织病理学结果
DOI：
10.1007/s00405-002-0455-0
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发表时间：
2002
影响因子：
2.6
通讯作者：
Christian Martin
中科院分区：
文献类型：
--
作者：
J. Prades;J. Dumollard;A. Timoshenko;L. Chelikh;F. Michel;B. Estour;Christian Martin
本研究的目的是评估多结节性甲状腺肿 (MNG) 双侧甲状腺近全切除术（残余甲状腺组织约 4 至 5 g）后的组织病理学结果。这 270 名患者包括 238 名女性和 32 名男性，平均年龄为 52 岁（范围：19-82 岁），患有累及整个腺体的 MNG，并在 1993 年至 1998 年期间接受过初次双侧手术。没有发生术中或术后死亡。 MNG手术的适应症包括疑似恶性肿瘤（7.7%）、甲状腺毒症（27.7%）、气管偏曲对颈部结构造成压力（38%）、年轻女性患者明显的外观畸形（6.6%）以及MNG胸腔内延伸（19.6%）。格雷夫氏病未包括在我们的研究中。手术标本重量范围为 60 至 560 克（平均 120 克）。最终病理结果为良性 237 例（87.8%），恶性 33 例（12.2%）。 19 例患者被诊断为宏观（10 例）或微观（9 例）乳头状癌：其中 2 例为滤泡型乳头状癌，3 例为淋巴瘤和桥本甲状腺炎，3 例为髓样癌，3 例为间变性癌，2 例为滤泡性癌，1 例为 Hürthle 细胞癌。仅对髓样癌患者和四名“高危”乳头状癌患者进行了真正的全甲状腺切除术。 4 名患者（1.4%）出现永久性（>12 个月）单侧复发性麻痹，10 名患者（3.7%）出现永久性（>12 个月）甲状旁腺功能减退症，14 名患者（5.1%）出现肥厚性或瘢痕疙瘩。我们的结果表明，对于 MNG 患者的各种组织病理学特征，具有最小残留组织的近全甲状腺切除术是一种通用的手术方法。观察到术后并发症发生率较低。
The purpose of this study was to assess histopathological findings after a bilateral near-total thyroidectomy (residual thyroid tissue about 4 to 5 g) for multinodular goiter (MNG). The 270 patients included 238 women and 32 men with a mean age of 52 years (range: 19–82 years) who had MNG involving the entire gland and had undergone a primary bilateral surgical procedure between 1993–1998. There was no intra- or postoperative mortality. Indications for the MNG surgery were suspected malignancy (7.7%), thyrotoxicosis (27.7)%, pressure on cervical structures with tracheal deviation (38%), significant cosmetic deformity in young female patients (6.6%) and intrathoracic extension of the MNG (19.6%). Grave's disease was not included in our study. The surgical specimen weight ranged from 60 to 560 g (average 120 g). Final pathological findings were benign in 237 patients (87.8%) and malignant in 33 patients (12.2%). Nineteen patients were diagnosed with macroscopic (ten patients) or microscopic (nine patients) types of papillary carcinoma: there were two patients with the follicular variant of papillary carcinoma, three with lymphoma and Hashimoto's thyroiditis, three with medullar carcinoma, three with anaplastic carcinoma, two with follicular carcinoma and one with Hürthle cell carcinoma. A true total completion thyroidectomy was performed only for the medullary carcinoma patients and for four of the "high-risk" papillary carcinoma patients. Permanent (>12 months) unilateral recurrent paralysis occurred in four patients (1.4%), permanent (>12 months) hypoparathyroidism in ten patients (3.7%) and hypertrophic or keloid scar in 14 patients (5.1%). Our results suggest that near total thyroidectomy with minimal residual tissue is a versatile surgical procedure for various histopathological features in MNG patients. Low rates of postoperative complications were observed.
影响因子：
5.6
作者：
Derringer, GA;Thompson, LDR;Abbondanzo, SL
通讯作者：
Abbondanzo, SL