■这篇综述文章总结了甲状腺乳头状癌患者预防性中央区淋巴结清扫术的最新证据,同时考虑到可能的并发症和复发风险。
■甲状腺乳头状癌是甲状腺恶性肿瘤最常见的组织学变异。它约占所有甲状腺癌病例的80-85%。尽管与许多其他恶性疾病相比,术后效果良好,生存率优异,肿瘤转移到颈部淋巴结是常见的。大多数研究人员同意,淋巴结中明显转移的存在需要仔细的淋巴结清扫。建议对所有涉及手术的恶性甲状腺疾病患者进行预防性常规淋巴结清扫。
■使用“甲状腺乳头状癌”进行了文献综述,“中央区淋巴结清扫术”,“低钙血症”,“喉返神经麻痹”,“转移”,“癌症复发”以及MESH术语。仔细审查了文章的参考列表,将其作为潜在的信息来源。搜索是基于Medline,Scopus,谷歌学者,eLibrary引擎。对选定的出版物进行分析,并将其合成用于撰写综述,并分析预防性中央区淋巴结清扫术在甲状腺乳头状癌患者中的作用。
■分化型甲状腺乳头状癌患者预防性中央区淋巴结清扫的必要性仍存在争议。有很多证据表明它增加了短暂性低钙血症的频率。由于这种并发症是暂时的,其在临床实践中的意义值得商榷。还可以假设,在颈部区域进行手术与喉返神经损伤的风险增加有关。然而,大多数研究表明,这种损伤与甲状腺切除术本身有关,而不是与淋巴结清扫有关。在绝大多数情况下,喉返神经功能障碍也是暂时的并发症。同时,大量数据显示,中央区淋巴结清扫可降低甲状腺癌复发的风险2倍。
UNASSIGNED: This review article summarises the latest evidence for preventive central lymph node dissection in patients with papillary thyroid cancer taking into account the possible complications and risk of recurrence.
UNASSIGNED: Papillary thyroid cancer is the most frequent histological variant of malignant neoplasms of the thyroid gland. It accounts for about 80-85% of all cases of thyroid cancer. Despite good postoperative results and an excellent survival rate in comparison with many other malignant diseases, tumor metastases to the cervical lymph nodes are frequent. Most researchers agree that the presence of obvious metastases in the lymph nodes requires careful lymph node dissection. It was suggested to perform preventive routine lymphadenectomy in all patients with malignant thyroid diseases referred to surgery.
UNASSIGNED: It was performed the literature review using the \"papillary thyroid cancer\", \"central lymph node dissection\", \"hypocalcemia\", \"recurrent laryngeal nerve paresis\", \"metastasis\", \"cancer recurrence\" along with the MESH terms. The reference list of the articles was carefully reviewed as a potential source of information. The search was based on Medline, Scopus, Google Scholar, eLibrary engines. Selected publications were analyzed and their synthesis was used to write the review and analyse the role of preventive central lymph node dissection in patients with papillary thyroid cancer.
UNASSIGNED: The necessity of preventive central lymph node dissection in patients with differentiated papillary thyroid carcinoma is still controversial. There is much evidence that it increases the frequency of transient hypocalcemia. Due to the fact that this complication is temporary, its significance in clinical practice is debatable. It can also be assumed that an extant of surgery in the neck area is associated with an increased risk of recurrent laryngeal nerve injury. However, most studies indicate that this injury is associated more with thyroidectomy itself than with lymph node dissection. Recurrent laryngeal nerve dysfunction is also a temporary complication in the vast majority of cases. At the same time, a large amount of data shows that central lymph node dissection reduces the risk of thyroid cancer recurrence in two times.