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美国临床内分泌医师协会(AACE)和美国头颈外科协会内分泌外科分会(AHNS)关于儿科良性和恶性甲状腺手术的共识声明。

Consensus Statement by the American Association of Clinical Endocrinology (AACE) and the American Head and Neck Society Endocrine Surgery Section (AHNS) on Pediatric Benign and Malignant Thyroid Surgery.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.

Maine Medical Partners Endocrinology & Diabetes Center, Scarborough, Maine.

出版信息

Endocr Pract. 2021 Mar;27(3):174-184. doi: 10.1016/j.eprac.2020.12.001. Epub 2020 Dec 10.

DOI:10.1016/j.eprac.2020.12.001
PMID:33779552
Abstract

OBJECTIVES

To provide a clinical disease state review of recent relevant literature and to generate expert consensus statements regarding the breadth of pediatric thyroid cancer diagnosis and care, with an emphasis on thyroid surgery. To generate expert statements to educate pediatric practitioners on the state-of-the-art practices and the value of surgical experience in the management of this unusual and challenging disease in children.

METHODS

A literature search was conducted and statements were constructed and subjected to a modified Delphi process to measure the consensus of the expert author panel. The wording of statements, voting tabulation, and statistical analysis were overseen by a Delphi expert (J.J.S.).

RESULTS

Twenty-five consensus statements were created and subjected to a modified Delphi analysis to measure the strength of consensus of the expert author panel. All statements reached a level of consensus, and the majority of statements reached the highest level of consensus.

CONCLUSION

Pediatric thyroid cancer has many unique nuances, such as bulky cervical adenopathy on presentation, an increased incidence of diffuse sclerosing variant, and a longer potential lifespan to endure potential complications from treatment. Complications can be a burden to parents and patients alike. We suggest that optimal outcomes and decreased morbidity will come from the use of advanced imaging, diagnostic testing, and neural monitoring of patients treated at high-volume centers by high-volume surgeons.

摘要

目的

提供近期相关文献的临床疾病综述,并针对儿科甲状腺癌的诊断和护理范围生成专家共识声明,重点关注甲状腺手术。生成专家声明,教育儿科医生有关该罕见且具有挑战性疾病的最新实践和手术经验价值。

方法

进行文献检索,并构建声明,然后将其提交给改良 Delphi 流程,以衡量专家作者小组的共识程度。声明的措辞、投票制表和统计分析由 Delphi 专家(J.J.S.)监督。

结果

创建了 25 个共识声明,并对其进行了改良 Delphi 分析,以衡量专家作者小组的共识程度。所有声明均达成共识,且大多数声明达到了最高共识水平。

结论

儿科甲状腺癌有许多独特的细微差别,例如就诊时颈部淋巴结肿大、弥漫性硬化性变体的发病率增加,以及治疗后可能需要更长的潜在寿命来承受潜在的并发症。并发症可能会给家长和患者带来负担。我们建议,通过高级成像、诊断测试和神经监测,由高容量外科医生在高容量中心治疗患者,可以获得最佳结果并降低发病率。

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