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갑상선 양성 종양으로 갑상선 부분절제술을 시행한 환자에서 수술 전후 갑상선 기능의 변화
황윤선,배수연,조동희,최민영,최준호,이정언,김지수,남석진,양정현,김정한,Yoon Sun Hwang,M.D.,Soo Youn Bae,M.D.,Dong Hui Cho,M.D.,Min-Young Choi,M.D.,Jun-Ho Choe,M.D.,Jeong Eon Lee,M.D.,Jee Soo Kim,M.D.,Seok Jin Nam,M.D.,Jung-Hyun Yan 대한갑상선-내분비외과학회 2010 The Koreran journal of Endocrine Surgery Vol.10 No.4
Purpose: Lobectomy or subtotal thyroidectomy in patients with a benign thyroid tumor or goiter can give rise to hypothyroidism due to the reduced volume of the hormone-secreting thyroid gland. This study investigated the incidence of hypothyroidism in such patients and the clinical risk factors. Methods: One hundred seven patients who underwent partial thyroidectomy for benign thyroid tumor or goiter from January 2003 to February 2005 in our institution were reviewed retrospectively. Patients who had been preoperatively diagnosed with hyper- or hypothyroidism preoperatively were excluded. Postoperative hypothyroidism was defined as an elevated serum thyroid stimulating hormone (TSH) level >6.5ՌIU/L at about 6 months post- thyroidectomy. Results: The mean age of the 107 patients was 42.2 years. Ninety patients (84.1%) were female. Subtotal thyroidectomy was performed in 20 patients, lobectomy in 83 patients and enucleation in four patients. The most common pathologic diagnosis was nodular hyperplasia (86.0%). Postoperative hypothyroidism developed after surgery in 19 (21.8%) patients. Patients were evaluated for age, gender, preoperative TSH level, tumor size, tumor number, extent of the resection, thickness of thyroid isthmus and the presence of pathologic thyroiditis or thyroid autoantibody. Advanced age, elevated preoperative TSH level and extensive resection of the thyroid gland were significantly associated with postoperative hypothyroidism. Conclusion: Since many patients with a benign thyroid nodule can maintain a normal thyroid function even after thyroidectomy, preservation of more thyroid tissue during the operation is desirable, especially in young patients with a low-normal TSH level, unless the possibility of disease recurrence is high. (Korean J Endocrine Surg 2010;10:213- 219)
정진호 ( Jin Ho Chung ),오승종 ( Seung Jong Oh ),정국현 ( Kuk Hyun Jung ),황윤선 ( Yoon Sun Hwang ),최민규 ( Min Gew Choi ),노재형 ( Jae Hyung Noh ),손태성 ( Tae Sung Sohn ),배재문 ( Jae Moon Bae ),김성 ( Sung Kim ),최성희 ( Seon 대한임상종양학회 2011 Korean Journal of Clinical Oncology Vol.7 No.2
목적: 본원에서 진단된 위 유암종의 임상병리학적 특성과 치료방법 및 예후에 대해 분석하였다. 방법: 1997년 1월 1일부터 2009년 12월 31일 까지 본원에서 병리조직검사 결과 위의 유암종으로 진단 및 치료 받은 52명의 환자를 대상으로 Rindi 분류에 따라 진단, 치료, 및 경과에 대해 후 향적 연구를 통해 분석하였다. 결과: 남자가 29명, 여자가 23명 (1.26:1) 이었고 평균나이는 54.6세이고 평균추적관찰 기간은 36개월이었다. 그 중 1형은 45 예로 40예(88.9%)에서 단일결절이며 만성위축성위염과 동반된 소견을 보였다. 2형은 2예로 복합내분비신생물 1형 증후군과 병발하였다. 3형은 5예로 모두 T2 이상의 병변이었다. 이들 환자중 절제가 가능한 49예중 12예에서 수술이 시행되었으며 37예에서 내시경적 용종절제술 및 점막하 절제술이 시행되었다. 52명중 3명이 사망하였고 1명이 유암종으로 인한 사망이었다. 결론: Rindi 분류를 통한 국내의 위 유암종은 악성빈혈이 동반되지 않았으며 남성이 더 많이 발생하며 단일결절이 많아 외국의 보고와는 다른 특징을 보였다. Purpose: We analyzed the clinicopathologic characteristics of patients with gastric carcinoid tumor, which is a rare gastric tumor Methods: We reviewed 52 carcinoid patients who were treated from 1997 to 2009. Carcinoids were classified as 3 types along the Rindi et al. The clinicopathologic characteristics, the treatment modalities were retrospectively analysed. Results: There were 29 man, and 28 woman patients.(1.26:1) The mean age of onset was 54.6 years. The average follow up period was 36 months. There were 40 of 45 type I patients who had solitary lesion and all of 45 patients combined with chronic atrophic gastritis. There were 2 type II paitents who combined with Multiple Endocrine Neoplasm type-1. There were 5 type III patients who had above T2 lesions. In the 49 patients who can resection, 12 underwent surgery, and 37 underwent endoscopic polypectomy and submucosal dissection. 3 of 52 patients death and only 1 case were death by disease. Conclusion: Higher incidence of gastric carcinoid tumor with man, less multiplicity, and no concurrence of pernicious anemia were identified in our study compared with previous reports.