Erfahrung mit der operativen Therapie von Schilddrüsenerkrankungen im Kindesalter

Kl, Waag; Hanisch, E.; Kollman, F; Wons, T; Wenisch, H J

doi:10.1055/s-2008-1043462

Cited by 4 publications

(5 citation statements)

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“…Graves disease demonstrates the most frequent cause of hyperthyroidism in children and adolescents. It makes up for 6% to over 30% (Angerpointer et al 1991, Waag et al 1988, Pistor et al 1990, Ladurner et al 1991, Rauh et al 1991, Hradec et al 1995 of all young surgical patients operated on for thyroid disorders (Table 2). Since primary treatment of also young patients with Graves disease is antithyroid drug therapy the question arises when a definitive therapy such as radioiodine or surgery is indicated.…”

Section: Discussionmentioning

confidence: 99%

Surgery for Graves disease in childhood and adolescence

Witte

Pe²,

Hd³

2009

Exp Clin Endocrinol Diabetes

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Children and adolescents with thyroid disorders are predominantly treated by pediatricians and pediatric endocrinologists. Surgery for thyroid disorders still represents the third frequent operation in adults in Germany, but is seldomly indicated in children. Thus children and adolescents make up for 1.3% of all our patients and of these 89 patients only 21 (23.6%) suffered from Graves disease. Nevertheless surgery for Graves disease in children and adolescence is recommended because medical therapy has proven a high rate of recurrences in children and because radioiodine is only reluctantly applied to children, at least in Germany.

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Section: Discussionmentioning

confidence: 99%

Surgery for Graves disease in childhood and adolescence

Witte

Pe²,

Hd³

2009

Exp Clin Endocrinol Diabetes

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“…Dennoch bleibt die euthyreote Knotenstruma die weitaus häufigste Operationsindikation (11,32,40,41 (40,41). Der Eingriff erfolgt als typische bilaterale, subtotale Resektion (1), wobei 90 % des Schilddrüsengewebes zu entfernen sind (22), der Parenchymrest 3-5 Gramm je nach Alter nicht überschreiten sollte (11,21,49 (25,49). Wellington (50) fand allerdings nur 18,5%.…”

Section: Postoperativer Verlaufunclassified

“…Bei Kindern und Jugendlichen ist jedoch aufgrund des höheren Malignitätsrisikos prinzipiell die Operation zu fordern. Im Frankfurter Krankengut war interessanterweise bei 33 % der betroffenen Erwachsenen eine Revision der histologischen Diagnose notwendig (49). Selbst die falsch negative Rate der Punktionszytologie erscheint zu groß.…”

Section: Postoperativer Verlaufunclassified

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Chirurgische Strategien bei Schilddrüsenerkrankungen im Kindes- und Jugendalter

Pistor

Waag²,

Kap-herr³

1990

Eur J Pediatr Surg

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In the Department of Paediatric Surgery of the University Hospital of Mainz and the Department of Paediatric Surgery of the University Hospital of Frankfurt/M 90 children with thyroid gland lesions were operated on between 1970 and 1988. 78 patients had benign findings and 12 had malignant tumours. The most frequent operative indication for benign lesions was the euthyroid goitre (57 patients). We found nodular goitre in 45 patients, cystic goitre in 11 patients, and diffuse goitre in only 1 patient. 20 children were suffering from hyperthyroidism (11 with Basedow's disease, 9 with autonomy) and 1 from Hashimoto's thyroiditis. Among the malignant tumours, papillary carcinomas were the most frequent (5 patients), followed by follicular carcinomas (2 patients) and C-cell carcinomas (2 patients), and 1 case each of C-cell hyperplasia, retothelial sarcoma and malignant lymphoma. The following operative interventions were necessary: Among the patients with the benign findings, 28 unilateral subtotal resections were done (17 right side and 11 left side). 24 lesions were enucleated, 24 goitres were subjected to subtotal bilateral resection; in 1 case subtotal resection on the right side and hemithyroidectomy on the left side was performed, and in one patient polresection was necessary. All the 12 patients with malignant tumours underwent thyroidectomy: In 4 cases one-step operations were done and in other 8 cases multistep operations were performed.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…unter Mitnahme der dorsalen Kapsel inklusive der Ausräumung zentraler Lymphknoten propagiert [8,11,13]. Die Recurrensparese von 1% und Hypoparathyreoidismusraten <1% weisen die Operation als relativ komplikationsarmen Eingriff aus, so dass aus heutiger Sicht im Hinblick auf die größtmögliche Radikalität die prophylaktische Operation gerechtfertigt erscheint [8].…”

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