{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T05:19:42Z","timestamp":1771305582371,"version":"3.50.1"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die pr\u00e4ventive Schilddr\u00fcsenchirurgie verfolgt das Ziel, das Auftreten maligner Erkrankungen zu verhindern oder deren Prognose zu verbessern. Die wesentliche Indikation ist das heredit\u00e4re medull\u00e4re Schilddr\u00fcsenkarzinom, die durch pathogene RET-Keimbahnvarianten verursacht wird. Hierbei k\u00f6nnen auch weitere klinische Manifestationen im Rahmen einer multiplen endokrinen Neoplasie auftreten. Eine fr\u00fchzeitige prophylaktische Thyreoidektomie im asymptomatischen Stadium kann diese Tumorentit\u00e4t dabei zu einer heilbaren Erkrankung machen. Hierbei richtet sich der Operationszeitpunkt nach dem Genotyp und der damit verbundenen Risikoklassifikation und Calcitonin-Werten, wobei besonders aggressive Mutationen bereits im 1. Lebensjahr eine Intervention erfordern.Im Gegensatz dazu ist der Nutzen einer prophylaktischen Lymphknotendissektion beim papill\u00e4ren Schilddr\u00fcsenkarzinom weiterhin umstritten: W\u00e4hrend einzelne Studien eine Senkung der Rezidivrate zeigen, ist das Risiko postoperativer Komplikationen wie Hypoparathyreoidismus oder Rekurrensparese erh\u00f6ht. Daher empfiehlt die aktuelle Leitlinie ein individualisiertes Vorgehen mit risikoadaptierter Indikationsstellung unter Ber\u00fccksichtigung von Tumorgr\u00f6\u00dfe, Histologie und molekularen Markern.Die Entfernung der Schilddr\u00fcse beseitigt zwar das Krebsrisiko, erfordert aber eine lebenslange Hormonsubstitution sowie eine engmaschige Nachsorge. Die Erweiterung des Eingriffs im Sinne einer prophylaktischen Lymphadenektomie kann hierbei die Morbidit\u00e4t erh\u00f6hen.Zuk\u00fcnftige Entwicklungen in der molekulargenetischen Diagnostik und eine verfeinerte Risikostratifizierung sollen helfen, Patientinnen und Patienten mit hohem onkologischem Risiko noch pr\u00e4ziser zu identifizieren und zugleich unn\u00f6tige Eingriffe zu vermeiden. Insgesamt zeigt sich, dass die pr\u00e4ventive Schilddr\u00fcsenchirurgie ein erfolgreiches Beispiel f\u00fcr personalisierte Pr\u00e4vention ist, deren Indikationsstellung zunehmend differenziert und patientenorientiert erfolgt.<\/jats:p>","DOI":"10.1055\/a-2752-1178","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T23:52:18Z","timestamp":1765410738000},"page":"51-56","source":"Crossref","is-referenced-by-count":1,"title":["Integration molekularer, genetischer und chirurgischer Erkenntnisse in die Indikationsstellung zur pr\u00e4ventiven Schilddr\u00fcsenchirurgie"],"prefix":"10.1055","volume":"151","author":[{"given":"Hatice","family":"Kesruek","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Kinderchirurgie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anni Valentina","family":"Kettner","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Crede","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Kinderchirurgie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Ghadimi","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Kinderchirurgie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Jo","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral- und Kinderchirurgie, Universit\u00e4tsmedizin G\u00f6ttingen, G\u00f6ttingen, 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