Wiadomosci lekarskie (Warsaw, Poland : 1960) · 2025
Diagnostic evaluation, risk stratification, and peri-surgical management strategies in thyroid disorders.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Gąsiorowski Oskar Patryk, Kaszczewska Joanna, Tarnowska Julia, Kaszczewski Piotr Krzysztof, Leszczyński Jerzy, Gałązka Zbigniew
Аннотация
OBJECTIVE: Aim: To discuss the indications for elective thyroid surgery and peri-surgical clinical strategy in patients with thyroid diseases.
PATIENTS AND METHODS: Materials and Methods: A comprehensive literature review was conducted from October 2024 to April 2025, analyzing relevant publications published between June 2005 and January 2024, sourced from PubMed, Scopus, Web of Science, and the Cochrane Library. Thyroid disorders encompass various conditions, including Graves' disease, hyperthyroidism, and thyrotoxicosis. Hypothyroidism manifests as subclinical or overt. Surgical indications for thyroidectomy include symptomatic nodules, indeterminate/Bethesda III-V cytology, malignancy (Bethesda VI), or compressive symptoms. Ultrasound-guided Fine-Needle Aspiration (FNA), based on nodule size and EU-TIRADS risk stratification, is pivotal for evaluation. Advanced aids in risk assessment. Surgical complications (hemorrhage, hypoparathyroidism, recurrence laryngeal nerve injury) require prompt management. Molecular testing refines indeterminate cytology diagnoses. Thyroidectomy is contraindicated in anaplastic cancer and/or high surgical risk cases. Postoperative monitoring for hypocalcemia, voice changes, and bleeding is essential.
CONCLUSION: Conclusions: Resource constraints hinder widespread adoption of advanced thyroid diagnostics, creating challenges in optimal nodule management.
PATIENTS AND METHODS: Materials and Methods: A comprehensive literature review was conducted from October 2024 to April 2025, analyzing relevant publications published between June 2005 and January 2024, sourced from PubMed, Scopus, Web of Science, and the Cochrane Library. Thyroid disorders encompass various conditions, including Graves' disease, hyperthyroidism, and thyrotoxicosis. Hypothyroidism manifests as subclinical or overt. Surgical indications for thyroidectomy include symptomatic nodules, indeterminate/Bethesda III-V cytology, malignancy (Bethesda VI), or compressive symptoms. Ultrasound-guided Fine-Needle Aspiration (FNA), based on nodule size and EU-TIRADS risk stratification, is pivotal for evaluation. Advanced aids in risk assessment. Surgical complications (hemorrhage, hypoparathyroidism, recurrence laryngeal nerve injury) require prompt management. Molecular testing refines indeterminate cytology diagnoses. Thyroidectomy is contraindicated in anaplastic cancer and/or high surgical risk cases. Postoperative monitoring for hypocalcemia, voice changes, and bleeding is essential.
CONCLUSION: Conclusions: Resource constraints hinder widespread adoption of advanced thyroid diagnostics, creating challenges in optimal nodule management.