Tiroid Kanseri Tedavisinde Boyun Diseksiyonu

Tiroid Kanseri Tedavisinde Boyun Diseksiyonu Endikasyon-Teknik Dr. Cihangir Özaslan

Prelaringeal, Paratracheal, Peritracheal Üst mediastinal Jugular

Lenf bezi metastazı ,[object Object],[object Object],[object Object],[object Object]

Lenf bezi metastazı ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Lenf bezi metastazı ,[object Object],[object Object],[object Object]

Lenf bezi metastazı ,[object Object],[object Object]

Evreleme ,[object Object],[object Object],[object Object],[object Object],[object Object]

Evreleme ,[object Object],[object Object]

Evreleme ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Nükslerin %60-75’i boyunda lenf nod met

<20 yaş ve >40-45 yaş nüks fazla >40 yaş mortalite fazla

yıl mortalite Ekstratiroid nod+ İntratiroid nod + İntratiroid nod -- Ekstratiroid nod --

Tedavi ,[object Object],[object Object]

Diseksiyon ,[object Object],[object Object]

Elektif diseksiyon ,[object Object],[object Object],[object Object]

Elektif diseksiyon ,[object Object],[object Object],[object Object],[object Object],Wang TS. AOHNS 2004; 130: 110-3.

Elektif diseksiyon ,[object Object],[object Object],[object Object],Wada N. Ann Surg 2003; 237: 399-407.

Beasley NJP. AOHNS. 128; 825-8, 2002.

Elektif Diseksiyon ,[object Object],[object Object],Kupferman ME. AOHNS 2004; 130: 857-60.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Vini L. Lancet Oncology 2002; 3: 407-14.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],Scheumann GFW. World J Surg. 1994; 18: 559-67.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Scheumann GFW. World J Surg. 1994; 18: 559-67.

Profilaktik Diseksiyon T1-4 T1-3 Scheumann GFW. World J Surg. 1994; 18: 559-67.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],[object Object],Tisell LE. World J Surg 1996, 20; 854-9.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],Mirallie E. World J Surg. 1999; 23: 970-4.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],Ito Y. World J Surg. 2006, 30; 1821-8.

Profilaktik Diseksiyon ,[object Object],[object Object],Ito Y. World J Surg. 2006; 30; 1821-8.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],[object Object],Machens A. World J Surg 2002; 26: 22-8

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Goropoulos A. World J Surg 2004, 28; 1275-81.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],[object Object],Leboulleux S. J Clin Endoc Met. 2005; 90: 5723-9.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],[object Object],[object Object],Pereira JA. Surgery 2005, 138; 1095-101.

Profilaktik Diseksiyon ,[object Object],[object Object],[object Object],Sywak M. Surgery 2006; 140: 1000-7.

Sentinel Lenf Nodu Örneklemesi ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Rubello D. Eur J Surg Oncol. 2006; 32: 917-21.

Sentinel Lenf Nodu Örneklemesi ,[object Object],[object Object],[object Object],[object Object],[object Object],Arch-Ferrer J. Surgery 2000; 130: 907-13. Catarci M. J Surg Oncol. 2001; 77: 21-4. Takami H. Asian J Surg. 2003; 26: 145-8. Chow TL. ANZ J Surg. 2004; 74:10-2. Dzadic R. World J Surg. 2006; 30: 841-6.

Elektif diseksiyon ,[object Object],[object Object],[object Object],Caron NR. World J Surg 2006; 30: 833-40.

Elektif diseksiyon ,[object Object],[object Object],Pingpank JF. AOHNS 2002; 128: 1275-78.

Medüller tiroid karsinomu ,[object Object],[object Object],[object Object],[object Object],[object Object]

Folliküler ve Hürthle Hücreli Karsinom ,[object Object],[object Object],[object Object],[object Object],[object Object]

Üst paratiroidleri korumak daha kolay, gerekirse ototransplantasyon Sağda rekürrenin anterior ve posteriorunda, Solda sadece anteriorunda lenf bezleri bulunur

Apron insizyonu Yarım apron insizyon Conley insizyon H insizyon Ankara Onkoloji Hastanesi

Y insizyon İki Y insizyon Mac Fee insizyon Schobinger insizyon Modiyiye Schobinger insizyon

Modifiye radikal boyun diseksiyonu Tip 1 +

Modifiye radikal boyun diseksiyonu Tip 2 + +

Modifiye radikal boyun diseksiyonu Tip 3

Komplikasyonlar ,[object Object],[object Object],[object Object],[object Object]

Komplikasyonlar ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tiroid Kanseri Tedavisinde Boyun Diseksiyonu

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