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Totale Thyreoidektomie mit Lymphknotendissektion des zentralen Kompartments beim nodal-positiven, organkapselinvasiven papillären Schilddrüsenkarzinom

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Total thyroidectomy with lymph node dissection of the central compartment for node-positive, capsular invasive papillary thyroid cancer

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Zusammenfassung

Operatives Prinzip der onkologischen Radikaloperation beim nodal-metastasierten Schilddrüsenkarzinom ist wie bei anderen onkologischen Eingriffen in der Viszeralchirurgie die anatomiebezogene Umsetzung des Konzepts der En-bloc („No-touch“)-Resektion des primärtumortragenden Organs einschließlich seiner ersten Lymphknotenstation unter Erhalt der zu schonenden Strukturen des Aerodigestivtrakts, der Rekurrensnerven und Nebenschilddrüsen. Anhand eines Operationsvideos, welches online zur Verfügung steht, wird die Operationstechnik detailliert dargestellt. Weiterhin werden Vor- und Nachteile der Technik diskutiert.

Abstract

The aim of radical oncological surgery for nodal metastasized papillary thyroid cancer is, as for other oncological interventions in visceral surgery, the anatomy-related implementation of the concept of en bloc (no touch) resection of the organ bearing the primary tumor together with the first lymph node station, while the structures of the aerodigestive tract, the recurrent laryngeal nerves and parathyroid glands are preserved. The surgical technique is demonstrated in detail with the help of a video of the operation and which is available on-line, the advantages and disadvantages of the technique are discussed.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. H. Dralle und P. Nguyen Thanh haben von der Firma Medtronic und der Firma Inomed finanzielle Unterstützungen zur Durchführung von Vortrags-, Kurs- bzw. Kongressveranstaltungen erhalten. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Falle von nicht mündigen Patienten liegt die Einwilligung eines Erziehungsberechtigen oder des gesetzlich bestellten Betreuers vor.

Author information

Correspondence to Prof. Dr. Dr. h.c. H. Dralle FRCS, FACS, FEBS.

Zusatzmaterial online

Video zu: Totale Thyreoidektomie mit Lymphknotendissektion des zentralen Kompartments(mp4 100MB)

Video zu: Totale Thyreoidektomie mit Lymphknotendissektion des zentralen Kompartments(mp4 100MB)

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Dralle, H., Nguyen Thanh, P. Totale Thyreoidektomie mit Lymphknotendissektion des zentralen Kompartments beim nodal-positiven, organkapselinvasiven papillären Schilddrüsenkarzinom. Chirurg 85, 895–903 (2014) doi:10.1007/s00104-014-2802-2

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Schlüsselwörter

  • Papilläres Schilddrüsenkarzinom
  • Totale Thyreoidektomie
  • Zentrale Halsdissektion
  • Nervus recurrens
  • Neuromonitoring
  • Video

Keywords

  • Papillary thyroid cancer
  • Total thyroidectomy
  • Central neck dissection
  • Recurrent laryngeal nerve
  • Neuromonitoring
  • Video