Title Kirurgija štitnjače u djece i adolescenata Title (english) Thyroid surgery in children and adolescents Author Ana Dobrić Mentor Mario Bilić (mentor)Committee member Srećko Branica (predsjednik povjerenstva)Committee member Mihael Ries (član povjerenstva)Committee member Mario Bilić (član povjerenstva)Granter University of Zagreb Defense date and country 2021-07-16, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Bolesti štitnjače koje zahtijevaju kirurško liječenje u populaciji djece i adolescenata izrazito su rijetke, pokazuju specifične kliničke karakteristike, te se samim time i postupak liječenja razlikuje uspoređujući sa adultnom populacijom. Benigne tireoidne bolesti koje nakon pravilno uzete anamneze, kliničkog pregleda, specifičnih laboratorijskih nalaza, UZV pregleda i ukoliko je potrebno citološke punkcije mogu zahtijevati kirurško liječenje jesu Gravesova bolest, folikularni i toksični adenomi te kongenitalne strume. Izbor kirurške metode ovisi o prethodnim iskustvima kirurga zaduženog za operativni zahvat, no najčešće se primjenjuju lobektomija ili subtotalna tireoidektomija, a iznimku predstavlja Gravesova bolest gdje je metoda izbora totalna tireoidektomija. Postoperativne komplikacije su u benignih tireoidnih bolesti nešto rjeđe nego u malignih zbog manjeg opsega kirurškog zahvata, najčešće su privremene, a uključuju hipoparatireoidizam i hipokalcijemiju, promuklost zbog ozljede nervusa laryngeusa recurrensa, krvarenje i infekciju rane. Navedene su komplikacije, od kojih neke i permanentne, puno učestalije kod opsežnijih kirurških zahvata poput totalne tireoidektomije i po potrebi disekcije vrata koje ujedno predstavljaju jednu od najučestalijih kirurških metoda u liječenju tiroidnih karcinoma. Najčešći je dobro diferencirani papilarni karcinom, a zatim folikularni i medularni tiroidni karcinomi sa nešto nižom incidencijom, te se većinom prezentiraju bezbolnom palpabilnom masom koja je za vrijeme postavljanja dijagnoze puno veća nego u odraslih i često multicentrična. Razlog odabira opsežnijeg i agresivnijeg kirurškog liječenja u tiroidnih maligniteta mlađe populacije jest i činjenica da se u vrijeme postavljanja dijagnoze prezentiraju sa već prisutnim lokoregionalnim metastazama i većim postotkom recidiva nakon provedenog kirurškog liječenja.
Abstract (english) Thyroid diseases that may require surgical treatment in children and adolescents are extremely rare, show specific clinical characteristics, and therefore the treatment is different in adults and children. Benign thyroid diseases that after a proper medical history, clinical examination, specific laboratory findings, ultrasound examination and, if necessary, cytological punctures may require surgical treatment are Graves' disease, follicular and toxic adenomas and congenital goiters. The choice of surgical method depends on the previous experience of the surgeon in charge of the operation, but lobectomy or subtotal thyroidectomy is the most often used one, with the exception of Graves' disease, where the method of choice is total thyroidectomy. Postoperative complications are less common in benign thyroid diseases than in malignancies, most often temporary, and include hypoparathyroidism and hypocalcemia, hoarseness due to laryngeal recurrence nerve injury, bleeding, and wound infection. Complications listed above, some of which can be permanent, are more common in extensive surgical procedures such as total thyroidectomy and, if necessary, neck dissection, which are also one of the most common surgical methods in the thyroid cancer treatment. The most common is well-differentiated papillary thyroid carcinoma, followed by follicular and medullary thyroid carcinomas with a slightly lower incidence, and are mostly presented by a painless palpable mass that is much larger at diagnosis than in adults and often multicentric. The reason for choosing more extensive and aggressive surgical treatment in thyroid malignancies in younger population is the fact that at the time of diagnosis they already present locoregional metastases and a higher recurrence rate after surgery.
Keywords
štitnjača
kirurgija
tireoidektomija
disekcija
djeca
adolescenti
Keywords (english)
thyroid gland
surgery
thyroidectomy
neck dissection
children
adolescents
Language croatian URN:NBN urn:nbn:hr:105:770324 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2022-02-01 12:33:18
