{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:00:45Z","timestamp":1785164445474,"version":"3.55.0"},"reference-count":19,"publisher":"Akademiai Kiado Zrt.","issue":"39","license":[{"start":{"date-parts":[[2024,9,29]],"date-time":"2024-09-29T00:00:00Z","timestamp":1727568000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2024,9,29]]},"abstract":"<jats:p>\n                    <jats:italic>Bevezet\u00e9s:<\/jats:italic>\n                    Pajzsmirigym\u0171t\u00e9t kapcs\u00e1n olyan seb\u00e9szi megold\u00e1sra\n                    kell t\u00f6rekedn\u00fcnk, amely egyszer\u0171v\u00e9 \u00e9s hat\u00e1soss\u00e1 teszi a hormonp\u00f3tl\u00e1st, \u00e9s\n                    megel\u0151zi a ki\u00fajul\u00e1st. Ennek a legink\u00e1bb az elvi lobectomia felel meg.\n                    <jats:italic>C\u00e9lkit\u0171z\u00e9s:<\/jats:italic>\n                    K\u00eds\u00e9rletet tesz\u00fcnk a biztons\u00e1gos radikalit\u00e1s\n                    krit\u00e9riumainak \u00e9s m\u0171t\u00e9ttechnikai aspektusainak meghat\u00e1roz\u00e1s\u00e1ra.\n                    <jats:italic>Anyag \u00e9s\n                        m\u00f3dszer:<\/jats:italic>\n                    2001 \u00e9s 2023 k\u00f6z\u00f6tt 2215 pajzsmirigym\u0171t\u00e9tet v\u00e9gezt\u00fcnk,\n                    melyek k\u00f6z\u00fcl 86,1% uni- vagy bilateralis lobectomia, 12,3% k\u00f6zel totalis\n                    resectio volt. Substernalis megjelen\u00e9ssel 28,9%-ban, m\u00edg recid\u00edv elv\u00e1ltoz\u00e1ssal\n                    5,3%-ban tal\u00e1lkoztunk. Partialis sternotomi\u00e1ra 1,8%-ban volt sz\u00fcks\u00e9g.\n                    <jats:italic>Eredm\u00e9nyek:<\/jats:italic>\n                    Az oper\u00e1lt 2215 pajzsmirigy-elv\u00e1ltoz\u00e1s 27,9%-a\n                    daganat, 19,6%-a hyperplasia, m\u00edg 18,1%-a gyullad\u00e1s volt. A 216 papillaris\n                    carcinoma patol\u00f3giai jellemz\u0151i k\u00f6z\u00fcl az okkult forma (42,1%), az enkapszul\u00e1lt\n                    megjelen\u00e9s (30,1%), a t\u00f6bbg\u00f3c\u00fas\u00e1g (26,4%), a k\u00e9toldali megjelen\u00e9s (12,5%) \u00e9s a\n                    kevert jelleg (8,3%) \u00e9rdemes kiemel\u00e9sre. A centr\u00e1lis r\u00e9gi\u00f3 41%-ban tartalmazott\n                    pozit\u00edv nyirokcsom\u00f3t. A daganatokban szignifik\u00e1nsan gyakoribb volt az egyidej\u0171\n                    Hashimoto-t\u00edpus\u00fa gyullad\u00e1s, mint a hyperplasia. \u00c1tmeneti nervus recurrens\n                    b\u00e9nul\u00e1s 3,3%-ban, m\u00edg definit\u00edv 0,49%-ban fordult el\u0151.\n                    <jats:italic>Megbesz\u00e9l\u00e9s:<\/jats:italic>\n                    A radikalit\u00e1st a lehet\u0151 legkisebb rezidu\u00e1lis\n                    \u00e1llom\u00e1ny el\u00e9r\u00e9se, m\u00edg a biztons\u00e1got az idegek \u00e9s a mell\u00e9kpajzsmirigyek\n                    funkci\u00f3j\u00e1nak meg\u0151rz\u00e9se jelenti. Ezt a k\u00e9t c\u00e9lt egyform\u00e1n vesz\u00e9lyeztet\u0151 t\u00e9nyez\u0151k:\n                    az \u00e1llom\u00e1nyban zajl\u00f3 gyullad\u00e1s, daganat, substernalis elhelyezked\u00e9s, recid\u00edva \u00e9s\n                    a fel nem ismert centr\u00e1lis paratrachealis nyirokcsom\u00f3\u00e1tt\u00e9t. A rutinszer\u0171\n                    idegprepar\u00e1l\u00e1ssal egybek\u00f6t\u00f6tt thyreoidectomia eredm\u00e9nyeit elemezve, csak a\n                    recid\u00edv elv\u00e1ltoz\u00e1sok eset\u00e9ben volt szignifik\u00e1nsan nagyobb a ki\u00fajult b\u00e9nul\u00e1sok\n                    sz\u00e1ma.\n                    <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic>\n                    A v\u00e9rmentes m\u0171t\u00e9ti ter\u00fclet biztos\u00edt\u00e1sa,\n                    az idegek prepar\u00e1l\u00e1s alatti h\u0171t\u00e9se, a fels\u0151 p\u00f3lus ereinek \u00e1gank\u00e9nti ell\u00e1t\u00e1sa,\n                    illetve a nem gyullad\u00e1sos sz\u00f6vet\u0171 pajzsmirigyek elt\u00e1vol\u00edt\u00e1sa sor\u00e1n szerzett\n                    preparat\u00edv gyakorlat seg\u00edti a biztons\u00e1gos radikalit\u00e1st nemcsak a daganatok, de a\n                    hyperplasia, gyullad\u00e1s, s\u0151t recid\u00edva miatt v\u00e9gzett thyreoidectomia sor\u00e1n is. Orv\n                    Hetil. 2024; 165(39): 1548\u20131557.\n                  <\/jats:p>","DOI":"10.1556\/650.2024.33132","type":"journal-article","created":{"date-parts":[[2024,10,1]],"date-time":"2024-10-01T06:21:29Z","timestamp":1727763689000},"page":"1548-1557","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":2,"title":["A biztons\u00e1gra t\u00f6rekv\u0151 radikalit\u00e1s helye, szerepe \u00e9s dilemm\u00e1i a pajzsmirigyseb\u00e9szet mindennapjaiban"],"prefix":"10.1556","volume":"165","author":[{"given":"Zolt\u00e1n","family":"Farsang","sequence":"first","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r, Sereg\u00e9lyesi \u00fat 4., 8000 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00f3bert","family":"Jask\u00f3","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r, Sereg\u00e9lyesi \u00fat 4., 8000 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erzs\u00e9bet","family":"R\u00e9v\u00e9sz","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r, Sereg\u00e9lyesi \u00fat 4., 8000 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Reich","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r, Sereg\u00e9lyesi \u00fat 4., 8000 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Szil\u00e1gyi","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, Patol\u00f3giai Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ron Gell\u00e9rt","family":"Altorjay","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, Biofizikai \u00e9s Sug\u00e1rbiol\u00f3giai Int\u00e9zet Budapest Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikl\u00f3s","family":"R\u00fcll","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, F\u00fcl-Orr-G\u00e9g\u00e9szeti \u00e9s Fej-Nyakseb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9va","family":"Benis","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r, Sereg\u00e9lyesi \u00fat 4., 8000 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zs\u00f3fia Kl\u00e1ra","family":"P\u00e1ncz\u00e9l","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r, Sereg\u00e9lyesi \u00fat 4., 8000 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ron","family":"Altorjay","sequence":"additional","affiliation":[{"name":"Fej\u00e9r V\u00e1rmegyei Szent Gy\u00f6rgy Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c1ltal\u00e1nos Seb\u00e9szeti Oszt\u00e1ly Sz\u00e9kesfeh\u00e9rv\u00e1r, Sereg\u00e9lyesi \u00fat 4., 8000 Magyarorsz\u00e1g"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Bliss RD, Gauger PG, Delbridge LW. Surgeon\u2019s approach to the thyroid\n                    gland: surgical anatomy and the importance of technique. World J Surg. 2000; 24:\n                    891\u2013897.","DOI":"10.1007\/s002680010173"},{"key":"R2","unstructured":"Bal\u00e1zs Gy, Cs\u00e1ky G, Luk\u00e1cs G. Endocrine surgery. In: Ga\u00e1l Cs. (ed.)\n                    Surgery. [Bal\u00e1zs Gy, Cs\u00e1ky G, Luk\u00e1cs G. Endokrin seb\u00e9szet. In: Ga\u00e1l Cs. (szerk.)\n                    Seb\u00e9szet.] Medicina K\u00f6nyvkiad\u00f3, Budapest, 2007; pp. 932\u2013950.\n                    [Hungarian]"},{"key":"R3","unstructured":"Altorjay \u00c1, Luk\u00e1cs G. Surgical interventions on the thyroid gland.\n                    In: Horv\u00e1th \u00d6P, Ol\u00e1h A, Szijj\u00e1rt\u00f3 A, et al. (eds.) Littmann operative surgery.\n                    2nd ed. [Seb\u00e9szeti beavatkoz\u00e1sok a pajzsmirigyen. In: Horv\u00e1th \u00d6P, Ol\u00e1h A,\n                    Szijj\u00e1rt\u00f3 A, et al. (szerk.) 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Head Neck 2013; 35: 934\u2013941.","DOI":"10.1002\/hed.23048"},{"key":"R15","doi-asserted-by":"crossref","unstructured":"Cirocchi R, Arezzo A, D\u2019Andrea V, et al. Intraoperative\n                    neuromonitoring versus visual nerve identification for prevention of recurrent\n                    laryngeal nerve injury in adults undergoing thyroid surgery. Cochrane Database\n                    Syst Rev. 2019; 1: CD012483.","DOI":"10.1002\/14651858.CD012483.pub2"},{"key":"R16","doi-asserted-by":"crossref","unstructured":"Orloff LA, Kuppersmith RB. American Thyroid Association\u2019s central\n                    neck dissection terminology and classification for thyroid cancer consensus\n                    statement. Otolaryngol Head Neck Surg. 2010; 142: 4\u20135.","DOI":"10.1016\/j.otohns.2009.11.013"},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Davies L, Welch HG. Increasing incidence of thyroid cancer in the\n                    United States, 1973\u20132002. JAMA 2006; 295: 2164\u20132167.","DOI":"10.1001\/jama.295.18.2164"},{"key":"R18","unstructured":"Ministry of Human Resources. Health guideline. Hungarian protocol of\n                    the diagnosis and treatment of differentiated thyroid cancer. [Az Emberi\n                    Er\u0151forr\u00e1sok Miniszt\u00e9riuma eg\u00e9szs\u00e9g\u00fcgyi szakmai ir\u00e1nyelve. A differenci\u00e1lt\n                    pajzsmirigyr\u00e1k diagnosztik\u00e1ja \u00e9s kezel\u00e9se.] E\u00fc K\u00f6zl. 2021; 71: 2643\u20132716.\n                    [Hungarian]"},{"key":"R19","doi-asserted-by":"crossref","unstructured":"Kov\u00e1cs GL, Hella Z, Vass Z, et al. Retrospective analysis of\n                    low-risk differentiated thyroid tumors: is lobectomy the adequate approach? [Kis\n                    rizik\u00f3j\u00fa differenci\u00e1lt pajzsmirigydaganatok retrospekt\u00edv anal\u00edzise: lobectomia a\n                    megfelel\u0151 v\u00e1laszt\u00e1s?] Orv Hetil. 2022; 163: 1074\u20131081.\n                    [Hungarian]","DOI":"10.1556\/650.2022.32493"}],"container-title":["Orvosi Hetilap"],"original-title":[],"link":[{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/165\/39\/article-p1548.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/165\/39\/article-p1548.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.akjournals.com\/downloadpdf\/journals\/650\/165\/39\/article-p1548.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:18:47Z","timestamp":1785161927000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.akjournals.com\/view\/journals\/650\/165\/39\/article-p1548.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,29]]},"references-count":19,"journal-issue":{"issue":"39"},"URL":"https:\/\/doi.org\/10.1556\/650.2024.33132","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,29]]}}}