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犬甲状腺癌双侧甲状腺叶同期切除术后的结局:15例病例(1994 - 2010年)

Outcome following simultaneous bilateral thyroid lobectomy for treatment of thyroid gland carcinoma in dogs: 15 cases (1994-2010).

作者信息

Tuohy Joanne L, Worley Deanna R, Withrow Stephen J

机构信息

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80526, USA.

出版信息

J Am Vet Med Assoc. 2012 Jul 1;241(1):95-103. doi: 10.2460/javma.241.1.95.

Abstract

OBJECTIVE

To evaluate the outcome of resection of simultaneous discrete bilateral mobile thyroid gland carcinomas (TGCs) in dogs.

DESIGN

Retrospective case series.

ANIMALS

15 dogs with resected simultaneous discrete bilateral mobile TGCs.

PROCEDURES

Medical records (from 1994 to 2010) were searched for dogs with the appropriate diagnosis and treatment. Information collected included signalment, clinical signs, diagnostic test results, tumor mobility (mobile tumor identified by movement ≥ 1 cm in all planes during palpation), complications, adjuvant treatments, and outcome.

RESULTS

Mobile, discrete, bilateral TGCs were removed in all dogs. Among the 15 dogs, complete parathyroidectomies were necessary in 9; parathyroid tissue was reimplanted in 4 and preserved in 2. Complications included hemorrhage and laryngeal nerve trauma, but without serious consequences. Thirteen dogs received calcitriol with or without supplemental calcium after surgery. In the immediate postoperative period, hypocalcemia developed and was corrected in 11 dogs. At the end of the study, 7 dogs continued to receive calcitriol with or without supplemental calcium, and 8 dogs required long-term thyroid hormone treatment. Six dogs received adjuvant chemotherapy. Local tumor recurrence or de novo distant metastasis was not detected at each dog's last follow-up examination. Median survival time was 38.3 months. Three dogs were lost to follow-up, 8 survived (4.3 to 77 months after surgery), and 4 died of unrelated causes.

CONCLUSIONS AND CLINICAL RELEVANCE

In dogs with TGCs undergoing bilateral thyroid lobectomies, a successful outcome can be expected, even when parathyroid gland tissue cannot be preserved. The role of adjuvant chemotherapy in treatment outcome was not clearly defined.

摘要

目的

评估犬双侧同时性散在可移动甲状腺癌(TGCs)切除的效果。

设计

回顾性病例系列研究。

动物

15只接受双侧同时性散在可移动TGCs切除的犬。

方法

检索1994年至2010年的病历,查找诊断和治疗合适的犬。收集的信息包括特征、临床症状、诊断检查结果、肿瘤可移动性(触诊时在所有平面移动≥1 cm确定为可移动肿瘤)、并发症、辅助治疗及结果。

结果

所有犬均切除了可移动、散在的双侧TGCs。15只犬中,9只需要进行完全甲状旁腺切除术;4只进行了甲状旁腺组织再植入,2只甲状旁腺组织得以保留。并发症包括出血和喉返神经损伤,但无严重后果。13只犬术后接受了骨化三醇治疗,部分补充了钙剂。术后即刻,11只犬出现低钙血症并得到纠正。研究结束时,7只犬继续接受骨化三醇治疗,部分补充了钙剂,8只犬需要长期甲状腺激素治疗。6只犬接受了辅助化疗。在每只犬的最后一次随访检查中均未发现局部肿瘤复发或新发远处转移。中位生存时间为38.3个月。3只犬失访,8只存活(术后4.3至77个月),4只死于非相关原因。

结论及临床意义

对于接受双侧甲状腺叶切除术的犬TGCs,即使甲状旁腺组织无法保留,也可预期获得成功的治疗效果。辅助化疗在治疗结果中的作用尚不明确。

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