Der Schilddrüsenknoten aus chirurgischer Sicht

Zusammenfassung

Die meisten Schilddrüsenknoten sind gutartig. Durch Ultraschall lassen sich 10-fach mehr Schilddrüsenknoten nachweisen im Vergleich zum Palpationsbefund. Die Beurteilung der Dignität eines Schilddrüsenknotens durch klinische Untersuchung, Ultraschall, Szintigrafie und Feinnadelaspirationsbiopsie ist eine entscheidende klinische Herausforderung und bestimmt die chirurgische Vorgehensweise. Bei gutartigen Erkrankungen und kleinen papillären Schilddrüsenkarzinomen (≤ 1 cm) reicht ein einseitiges Vorgehen, sonst muss thyreoidektomiert werden. Die minimalinvasive videoassistierte Thyreoidektomie (MIVAT) erzielt günstige kosmetische Ergebnisse.

Abstract

Most of the thyroidal nodules are of benign origin. Compared to palpation 10 times more nodules can be seen by sonography. The evaluation by clinical work-up, sonography, scintigraphy and fine needle aspiration biopsy (FNAB) determines the surgical approach. In benign diseases and small papillary cancer (≤ 1 cm) an unilateral resection is sufficient, otherwise a thyroidectomy is indicated. Minimal invasive videoassisted thyroidectomy (MIVAT) offers improved cosmetic results.

Schlüsselwörter

Schilddrüsenknoten - Thyreoidektomie - minimalinvasive video-assistierte Thyreoidektomie - MIVAT

Key words

thyroid nodule - thyroidectomy - minimal invasive video assisted thyroidectomy - MIVAT

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