Técnicas de localización para la escisión quirúrgica guiada de los tumores tiroideos cervicales no palpables
Resumen Introducción y objetivo: La cicatrización y los planos tisulares alterados se suman a la ya compleja anatomía del cuello y dificultan la localización de recidivas o metástasis no palpables en las reintervenciones cervicales del cáncer de tiroides. Síntesis: Describimos el uso de diversos técnicos de señalización empleadas para optimizar la cirugía y los resultados terapéuticos de pacientes con carcinoma papilar de tiroides con enfermedad cervical persistente o metastásica. Especialmente nos centramos en la técnica de localización utilizando semillas radiactivas (RSL) en la que se ha descrito, al igual que en la mama, excelentes resultados. Conclusiones: La RSL es una técnica segura, asociada a una mayor satisfacción del cirujano, con excelente tolerancia por el paciente, que, además, reduce el tiempo de la intervención quirúrgica proporciona mejores resultados cosméticos reduciendo el riesgo de morbilidad en comparación con el uso de colorantes, arpones y tatuajes. Además, permite el desacoplamiento completo de los programas de radiología y cirugía optimizando los tiempos y la programación de los quirófanos.
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Lang BH-H, Lee GCC, Ng CPC, Wong KP, Wan KY, Lo C-Y. Evaluating the morbidity and efficacy of reoperative surgery in the central compartment for persistent/recurrent papillary thyroid carcinoma. World J Surg [Internet]. 2013 [citado el 20/04/2019]; 37(12):2853–2859. Disponible en: https://link.springer.com/10.1007/s00268-013-2202-7
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Coquia SF, Chu LC, Hamper UM. The role of sonography in thyroid cancer. Radiol Clin North Am. 2014 Nov 1; 52(6):1283–1294.
Giles YS, Sarici IS, Tunca F, Sormaz IC, Salmaslio?lu A, Adalet I, et al. The rate of operative success achieved with radioguided occult lesion localization and intraoperative ultrasonography in patients with recurrent papillary thyroid cancer. Surg (United States) [Internet]. 2014 [citado el 20/04/2019]; 156(5):1116–1126. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0039606014001822
Di Meo G, Prete FP, De Luca GM, Pasculli A, Sgaramella LI, Minerva F, et al. The value of intraoperative ultrasound in selective lateral cervical neck lymphadenectomy for papillary thyroid cancer: A prospective pilot study. Cancers (Basel). 2021; 13(11):2737.
Ertas B, Kaya H, Kurtulmus N, Yakupoglu A, Giray S, Unal OF, et al. Intraoperative ultrasonography is useful in surgical management of neck metastases in differentiated thyroid cancers. Endocr 2014 481 [Internet]. 2014 [citado el 16/10/2021]; 48(1):248–253. Disponible en: https://link.springer.com/article/10.1007/s12020-014-0287-x
Karwowski JK, Jeffrey RB, McDougall IR, Weigel RJ, Monchik JM, McHenry CR, et al. Intraoperative ultrasonography improves identification of recurrent thyroid cancer. Surgery [Internet]. 2002 [citado el 12/10/2021]; 132(6):924–929. Disponible en: https://pubmed.ncbi.nlm.nih.gov/12490837/
Sippel RS, Elaraj DM, Poder L, Duh Q-Y, Kebebew E, Clark OH. Localization of Recurrent Thyroid Cancer Using Intraoperative Ultrasound-Guided Dye Injection. World J Surg [Internet]. 2009 [citado el 08/06/2019]; 33(3):434–439. Disponible en: https://www.ncbi.nlm.nih.gov/pubmed/18958519
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