UNASSIGNED:为确定局部浸润性分化型甲状腺癌(DTC)患者的手术范围制定循证建议。局部侵入性DTC伴甲状腺外粗大延伸侵入周围解剖结构可能导致多种功能缺陷和不良的肿瘤学结果。目前,局部侵入性DTC的最佳手术范围仍存在争议;目前尚无足够的指南.
UNASSIGNED:2021年10月8日,四位专家搜索了PubMed,EMBASE,和Cochrane图书馆数据库;确定的论文由39名甲状腺和头颈部手术专家进行了审查。建议的分级,评估,发展,采用评估(等级)方法评估证据质量,并制定和报告建议。建议的强度反映了指南小组的信心,即干预措施的预期效果超过任何不良效果,适用于该建议的所有患者。在完成准则草案之后,Delphi问卷由韩国头颈外科学会成员完成。
未经评估:针对几个因素提出了27项基于证据的建议,包括术前检查;甲状腺切除术的手术范围;癌症侵入带状肌肉时的手术,喉返神经,喉框架,气管,或食道;以及中央和外侧颈淋巴结受累的患者的手术。
UNASSIGNED:循证指南旨在帮助临床医生为局部侵入性DTC患者的最佳手术治疗做出更安全、更有效的临床决策。
The aim of this study was to develop evidence-based recommendations for determining the surgical extent in patients with locally invasive differentiated thyroid cancer (DTC). Locally invasive DTC with gross extrathyroidal extension invading surrounding anatomical structures may lead to several functional deficits and poor oncological outcomes. At present, the optimal extent of surgery in locally invasive DTC remains a matter of debate, and there are no adequate
guidelines. On October 8, 2021, four experts searched the PubMed, Embase, and Cochrane Library databases; the identified papers were reviewed by 39 experts in thyroid and head and neck surgery. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence, and to develop and report recommendations. The strength of a recommendation reflects the confidence of a
guideline panel that the desirable effects of an intervention outweigh any undesirable effects, across all patients for whom the recommendation is applicable. After completing the draft
guidelines, Delphi questionnaires were completed by members of the Korean Society of Head and Neck Surgery. Twenty-seven evidence-based recommendations were made for several factors, including the preoperative workup; surgical extent of thyroidectomy; surgery for cancer invading the strap muscles, recurrent laryngeal nerve, laryngeal framework, trachea, or
esophagus; and surgery for patients with central and lateral cervical lymph node involvement. Evidence-based
guidelines were devised to help clinicians make safer and more efficient clinical decisions for the optimal surgical treatment of patients with locally invasive DTC.