甲状腺手术技术的应用:拉丁美洲甲状腺学会外科事务委员会专家意见。第1部分。

IF 1.6 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM
Alvaro Sanabria, Jose Luis Novelli, Erivelto Volpi, Ana Voogd, Santiago Zund, Luiz Paulo Kowalski, Juan Pablo Dueñas
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引用次数: 0

摘要

甲状腺切除术是治疗甲状腺肿、甲状腺癌和巴塞杜氏病等疾病最常用的内分泌外科疗法。甲状腺肿大的全球发病率在5%-20%之间,在不太富裕的国家发病率尤其高,而甲状腺癌的发病率则由于影像诊断技术的广泛应用而呈上升趋势。尽管可以选择药物治疗,但手术仍然必不可少。血管封闭技术、术中喉神经监测技术(IONM)、远程手术和甲状旁腺荧光技术等手术技术的进步改变了甲状腺手术。血管封闭技术缩短了手术时间并减少了失血量,而术中喉部神经监测技术则保留了喉部神经。远程手术包括多种技术,其效果与开放式甲状腺切除术相似,但手术时间更长。荧光技术可提高甲状旁腺检测能力,降低暂时性甲状旁腺功能减退的风险。经济学研究显示了成本差异,在依赖手术时间的医疗系统中优势尤为明显。虽然这些先进技术有望为患者带来更好的治疗效果,但其可及性和成本效益仍然是个问题,尤其是在拉丁美洲。考虑到这些问题,拉丁美洲甲状腺学会外科事务委员会对新兴的甲状腺外科技术进行了广泛的审查,以确保这些技术在该地区的合理应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of technologies in thyroid surgery: Latin American Thyroid Society Surgical Affairs Committee Expert Opinion. Part 1.

Thyroidectomyis the most frequent endocrine surgical treatment for problems such as goiter, thyroid cancer, and Graves' disease. The global incidence of goiter ranges from 5%-20%, with a notably high frequency in less wealthy countries, and the incidence of thyroid cancer is on the rise due to the greater use of diagnostic imaging. Despite medical options, surgery remains essential. Surgical advancements such as blood vessel sealing technology, intraoperative laryngeal nerve neuromonitoring (IONM), remote access surgery, and parathyroid fluorescence have transformed thyroid surgery. Vessel sealing technologies reduce operative time and blood loss, whereas IONM preserves the laryngeal nerves. Remote access surgery, which includes a variety of techniques, produces results similar to those of open thyroidectomy with a longer operative time. Fluorescence enhances parathyroid detection and lowers the risk of temporary hypoparathyroidism. Economic studies reveal cost discrepancies, with advantages particularly visible in health care systems that depend on surgical time. While these advancements promise better patient outcomes, their accessibility and cost-effectiveness remain issues, particularly in Latin America. Recognizing these concerns, the Latin American Thyroid Society's Surgical Affairs Committee conducted an extensive review of emerging thyroid surgery technologies to guarantee their proper use in the area.

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来源期刊
Archives of Endocrinology Metabolism
Archives of Endocrinology Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
2.90
自引率
5.90%
发文量
107
审稿时长
7 weeks
期刊介绍: The Archives of Endocrinology and Metabolism - AE&M – is the official journal of the Brazilian Society of Endocrinology and Metabolism - SBEM, which is affiliated with the Brazilian Medical Association. Edited since 1951, the AE&M aims at publishing articles on scientific themes in the basic translational and clinical area of Endocrinology and Metabolism. The printed version AE&M is published in 6 issues/year. The full electronic issue is open access in the SciELO - Scientific Electronic Library Online e at the AE&M site: www.aem-sbem.com. From volume 59 on, the name was changed to Archives of Endocrinology and Metabolism, and it became mandatory for manuscripts to be submitted in English for the online issue. However, for the printed issue it is still optional for the articles to be sent in English or Portuguese. The journal is published six times a year, with one issue every two months.
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