연세대학교 · 의학
Jandee Lee 교수의 연구실은 갑상선암 치료의 최적화를 목표로 하며, 특히 로봇 수술 기반 갑상선절제술과 내시경 수술의 임상적 유효성 및 환자 중심 결과를 중심으로 연구를 진행하고 있습니다. 환자의 삶의 질 향상, 미용 결과 향상, 신경학적 합병증 감소 등을 고려한 최신 수술 기법의 평가와 함께, 갑상선암 환자의 장기 예후 및 재발 위험도 분석에도 주력하고 있습니다. 특히 PTMC(작은 갑상선암) 환자에서의 수술 범위 결정 및 추적 관찰 전략에 대한 근거를 마련하고자 합니다.
표시된 성과는 수집된 데이터 기준으로 산출되며, 일부 차이가 있을 수 있습니다.
Our study indicates that use of rhTSH preserves QoL in patients undergoing RI ablation and affords an ablation success rate comparable to that seen after thyroid hormone withdrawal. Notably, ablation preparation using withdrawal of LT3 for 2 weeks did not prevent development of profound hypothyroidism, as also occurred when LT4 alone was withdrawn for 4 weeks.
Robotic TT with MRND yielded similar oncologic outcomes and safety as conventional open procedures, with similar recovery of neck and shoulder disability. However, the robot technique resulted in better QoL outcomes, including better cosmetic results and reductions in neck sensory changes and swallowing discomfort.
Our study showed that DTC patients presenting with initial DM appear to have relatively favorable outcomes compared with DTC patients who developed DM after initial treatment. Complete local control may be the most important prognostic indicator in all DM patients. Metastatic lesion iodine avidity had a significant impact on both OS and DSS in patients developing DM after initial treatment, but significantly influenced only DSS in patients presenting with initial DM.
The long-term rates of death and locoregional recurrence were similar in patients with PTMC who underwent LT with CCND and those who underwent TT with CCND. Therefore, completion thyroidectomy may not be recommended unless recurrence after LT is definitely detected in low-risk PTMC patients, and close follow-up is adequate in these patients. Moreover, tumor size greater than or less than 0.5 cm was not a significant determinant of the extent of surgery in patients with PTMC.
The advantages of endoscopic thyroidectomy and neck dissection include reduced hyperesthesia or paresthesia in the neck and favorable cosmetic outcomes. However, endoscopic thyroidectomy with neck dissection has a long learning curve, as well as technical limitations associated with a 2-dimensional view and a reduced dexterity of movement, particularly when operating in deep and narrow spaces such as the neck area. A robotic approach has been developed to overcome these limitations, facilitating
Robotic thyroidectomy is an emerging technique with postoperative outcomes that are at least comparable to those of conventional endoscopic thyroidectomy, with some end-points appearing superior. Our multicenter series represents the largest comparison of robotic and endoscopic thyroidectomy to date, with results suggesting a comparable robot technology we used that could overcome some of the technical limitations associated with conventional endoscopic procedures, with reduced operation times a
A level IIb LND should be performed when there is clinical or radiological evidence of lymphatic metastasis. In the absence of such evidence, the findings suggest that level IIb LND is not necessary in N1b PTC patients when there is no level IIa LN metastasis, or when the metastasis is not aggressive.
Robotic surgery is an innovation in thyroid surgery that may compensate for the drawbacks of conventional endoscopic surgery. A surgical robot provides strong advantages, including three-dimensional imaging, motion scaling, tremor elimination, and additional degrees of freedom. We review here recent adaptations, experience and applications of robotics in thyroid surgery. Robotic thyroid surgeries include thyroid lobectomy, total thyroidectomy, central compartment neck dissection, and radical nec
The accumulated evidence to date suggests that robotic thyroidectomy and MRND can benefit both patients and surgeons.
A proportion of patients designated as intermediate risk by the ATA 2009-RSS were designated as low risk by the ATA 2015-RSS. The ATA 2015-RTR may be the most accurate predictor of risk of recurrence.
Recently, the 2015 American Thyroid Association (ATA) risk stratification and the 8<sup>th</sup> edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM staging system were released. This study was conducted to assess the clinical value of the lymph node ratio (LNR) as a predictor of recurrence when integrated with these newly released stratification systems, and to compare the predictive accuracy of the modified systems with that of the newly rel