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甲状舌管分支是否会影响儿童 Sistrunk 手术的术后结果?

Does thyroglossal duct arborization play a role in the post-surgical outcome of Sistrunk procedure in children?

机构信息

Division of Pediatric and Adolescent Surgery, Department of Surgery, University of Pisa, Pisa, Italy.

Department of Surgical, Medical, Molecular Pathology and Critical Area, University of Pisa, Pisa, Italia.

出版信息

Eur Arch Otorhinolaryngol. 2024 Jul;281(7):3791-3796. doi: 10.1007/s00405-024-08631-y. Epub 2024 Apr 9.

Abstract

PURPOSE

The purpose of the present study is to analyze thyroglossal duct cyst (TGDC) histopathological features, with focus on "arborization", in a cohort of pediatric patients who underwent surgical removal, and evaluate a possible correlation with clinical recurrences.

METHODS

A retrospective analysis of all patients who underwent surgical resection for TGDC at the division of Pediatric Surgery of the University of Pisa from 2015 to 2020 was performed; for each patient, the following data were recorded: age, sex, clinical presentation, localization, size of the lesion, diagnostic tools, histopathological features, perioperative complications, recurrence and follow-up.

RESULTS

With respect to arborization, following histopathological analysis 25/30 patients (83.3%) presented thyroglossal duct branching. After a median follow-up of 3.5 years, only 2 out of 30 patients (6.7%), one male and one female, respectively aged 4 y.o. and 6 y.o., presented recurrence within one year from first surgery.

CONCLUSION

Surgery for TGDC remains a challenge for pediatric surgeons, while arborization was present in most of our cases which underwent surgery. With respect to the role of arborization, our study did not highlight sufficient conclusive data regarding their role in recurrence: instead, it showed wide resection as satisfactory, being the arborization present in most of the cases at histopathology.

摘要

目的

本研究旨在分析儿童患者行甲状腺舌管囊肿(TGDC)切除术的组织病理学特征,重点分析“分支”现象,并评估其与临床复发的相关性。

方法

对 2015 年至 2020 年期间在比萨大学小儿外科分部行 TGDC 切除术的所有患者进行回顾性分析;记录每位患者的年龄、性别、临床表现、位置、病变大小、诊断工具、组织病理学特征、围手术期并发症、复发和随访情况。

结果

根据组织病理学分析,25/30 例(83.3%)患者存在甲状腺舌管分支。中位随访 3.5 年后,仅 2/30 例(6.7%)患者,分别为 4 岁和 6 岁的男性和女性,在首次手术后 1 年内复发。

结论

对于小儿外科医生来说,TGDC 的手术仍然具有挑战性,而我们手术的大多数病例都存在分支。关于分支的作用,本研究没有提供足够的结论性数据来证明其与复发的关系:相反,研究表明广泛切除是令人满意的,因为组织病理学上大多数病例都存在分支。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/152d/11211129/39f439c2c33f/405_2024_8631_Fig1_HTML.jpg

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