Recomendaciones para el manejo quirúrgico actual del nódulo tiroideo maligno

Abstract

Surgery remains the cornerstone of thyroid cancer treatment. Greater access to imaging studies now allows for the diagnosis of nodules at earlier stages. While this improves diagnostic performance, it also requires careful evaluation to avoid overdiagnosis and overtreatment. In this context, less aggressive surgical procedures, such as lobectomy or partial thyroidectomy, or less invasive approaches, have gained relevance in recent years. Proper preoperative evaluation and planning by the surgeon and a multidisciplinary team is essential to offer personalized treatment to each patient. Advances in anesthesia, the use of energy instruments for hemostasis, and intraoperative monitoring of the laryngeal nerve have improved surgical safety, although they do not replace the surgeon's meticulous technique or clinical judgment. Remote access routes and radiofrequency ablation techniques represent surgical management alternatives for selected cases of patients with thyroid cancer. The objective of this review is to analyze the current status of diagnosis and surgical treatment of this pathology.