分化型甲状腺癌术后复发再手术术前评估

Preoperative evaluation of reoperation for postoperative recurrence of differentiated thyroid cancer

尽管大多数甲状腺癌总体预后良好,但由于诊疗的不规范和疾病的自身特点仍有一部分病人存在术后复发的风险,这将给病人身心健康和经济方面带来巨大负担,同时也给甲状腺专科医师的诊治带来很大的挑战。不同于甲状腺癌的初始治疗,复发病灶的临床具体处理过程更为复杂,而其关键的前提在于完善术前的精准评估,包括既往手术病史、现有疾病分析、病人的体质、再次手术风险与获益等各方面。对于复发灶的再次手术,主要目的在于可以完全清除复发病灶使其不再复发,同时尽可能减少病人生理功能的损害和保障病人生活质量。因此,如何实现甲状腺癌复发病灶的术前精准评估,实现手术的根治性和功能保护的统一,是值得甲状腺专科医生探讨的问题。

Although the overall prognosis of most thyroid cancer is good,due to the nonstandard diagnosis and treatment and the characteristics of the disease,some patients still have the risk of postoperative recurrence,which will not only bring them a huge burden on physical and mental health and the financial difficulties,but also pose a great challenge for the surgeons to diagnose and treat the disease.Different from the original ecological initial treatment,the specific clinical treatment process to recurrent lesions is more complicated,and the key premise is to improve the accurate preoperative evaluation,including the previous surgical history,existing disease analysis,the patient’s constitution,the balance between the risk and benefit of reoperation and other factors.For the reoperation of recurrent lesions,the main purpose is to remove the recurrent lesions completely so that they will not recur,and at the same time,minimizing the physiological function damage of patients as much as possible and ensuring the patients’ quality of life.Therefore,how to achieve accurate preoperative evaluation of recurrent thyroid lesions,to achieve the unity of radical surgery and functional protection,is worthy of thyroid specialists to explore.