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关于低、中分化甲状腺癌行甲状腺全切术与甲状腺原发手术的持续争论:一项荟萃分析

The Ongoing Debate Regarding Completion Thyroidectomy Versus Primary Thyroid Surgery for Low and Intermediate Differentiated Thyroid Carcinoma: A Meta-Analysis.

作者信息

Mirghani Hyder, Altedlawi Albalawi Ibrahim A

机构信息

Medicine, University of Tabuk, Tabuk, SAU.

Surgical Oncology, University of Tabuk, Tabuk, SAU.

出版信息

Cureus. 2020 Dec 11;12(12):e12033. doi: 10.7759/cureus.12033.

Abstract

Lobectomy is increasingly performed for low-risk differentiated thyroid cancer (DTC) and papillary thyroid microcarcinoma (PTMC). However, there is a continuous controversy about completion thyroidectomy (CT) following lobectomy. The current meta-analysis aimed to assess the outcomes of the initial surgical procedure versus CT performed for low/intermediate-risk thyroid carcinoma. Six hundred and sixty-one articles were retrieved, and only 15 full texts fulfilled the inclusion and exclusion criteria. There were 15 studies, including 17,143 patients; twelve were retrospective, two prospective studies, and a controlled trial. Seven articles were from Asia, four from the USA, two from Europe, while two were published in Canada. The studies showed no difference between lobectomy and primary thyroid surgery regarding post-surgery complications. CT was not different from the initial surgical procedure in terms of complications for DTC. The study was limited by the retrospective studies included, the outcomes assessed were not uniform, and significant heterogeneity was observed. Further, well-controlled, more specific trials are needed.

摘要

对于低风险分化型甲状腺癌(DTC)和甲状腺微小乳头状癌(PTMC),肺叶切除术的实施越来越多。然而,肺叶切除术后的甲状腺全切术(CT)一直存在争议。当前的荟萃分析旨在评估针对低/中风险甲状腺癌进行的初始手术与甲状腺全切术的结果。检索到661篇文章,只有15篇全文符合纳入和排除标准。共有15项研究,包括17143例患者;12项为回顾性研究,2项为前瞻性研究,还有1项对照试验。7篇文章来自亚洲,4篇来自美国,2篇来自欧洲,2篇发表于加拿大。研究表明,肺叶切除术和初次甲状腺手术在术后并发症方面没有差异。对于DTC,甲状腺全切术在并发症方面与初始手术没有差异。该研究受到纳入的回顾性研究的限制,评估的结果不一致,并且观察到显著的异质性。此外,需要进行更严格控制、更具针对性的试验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a9b/7734888/a1da02683596/cureus-0012-00000012033-i01.jpg

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