关键词: 甲状腺肿瘤, 乳头状癌, 微小癌, 外科治疗

Abstract:

Consensus and controversy on surgical treatment of papillary thyroid microcarcinoma        ZHANG Hao. Department of Thyroid Surgery，the First Hospital of China Medical University，Shenyang 110001，China
Abstract    The therapeutic strategies and choice of operation of papillary thyroid microcarcinoma (PTMC) remain controversial. An active surveillance is not suitable for the actual condition and medical environment in China, which should not be excessively popularized, unless there is a gold standard to distinguish indolent and aggressive PTMC. Surgery is the first choice for PTMC that is diagnosed definitely. Guidelines at home and abroad are essentially the same for the extent of thyroidectomy. Thyroid lobectomy plus isthmectomy is chosen for low-risk patients and total/near total thyroidectomy should be performed for intermediate- to high-risk patients. It’s advocated that at least ipsilateral central-compartment neck dissection should be performed and prophylactic lateral neck compartmental lymph node dissection is not necessary for PTMC. It’s recommended that individualized therapy should be chosen by the comprehensive evaluation of the available risk factors and the considerations of the patients’ preference, the skills of the surgeon, and the balance of complications and the risk of disease.

Key words: thyroid neoplasms, papillary carcinoma, microcarcinoma, surgical treatment