{"id":91,"date":"2017-02-01T14:15:45","date_gmt":"2017-02-01T12:15:45","guid":{"rendered":"http:\/\/kogital.com\/clients\/leventkabasakal\/?page_id=91"},"modified":"2019-03-04T13:03:33","modified_gmt":"2019-03-04T11:03:33","slug":"tiroit-nodulleri","status":"publish","type":"page","link":"https:\/\/www.leventkabasakal.com\/en\/diseases\/tiroit\/tiroit-nodulleri\/","title":{"rendered":"(Turkish) T\u0130RO\u0130D NOD\u00dcLLER\u0130"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-331 size-full\" src=\"http:\/\/wp1031.hostgator.com\/~waeas20acpgc\/wp-content\/uploads\/2017\/02\/tiroit-nodul.jpg\" alt=\"Tiroit nod\u00fcl\u00fc\" width=\"287\" height=\"411\" srcset=\"https:\/\/www.leventkabasakal.com\/wp-content\/uploads\/2017\/02\/tiroit-nodul.jpg 287w, https:\/\/www.leventkabasakal.com\/wp-content\/uploads\/2017\/02\/tiroit-nodul-209x300.jpg 209w\" sizes=\"auto, (max-width: 287px) 100vw, 287px\" \/>Tiroid nod\u00fcllerinin s\u0131kl\u0131\u011f\u0131 toplumdan topluma de\u011fi\u015fim g\u00f6stermekle birlikte hassas ultrasonografilerin kullan\u0131ma girmesiyle belirgin bi\u00e7imde artm\u0131\u015ft\u0131r. \u00d6zellikle bizim \u00fclkemizdeki gibi iyot eksikli\u011fi \u00e7ekilen toplumlarda bu oran %50-60\u2019lara varmaktad\u0131r.Nodul Bir ba\u015fka deyi\u015fle her 100 ki\u015fiden 50-60\u2019\u0131nda tiroid nod\u00fclleri g\u00f6r\u00fclmektedir. Bu tiroid nod\u00fcllerinin hepsinin ameliyat olmas\u0131 veya hepsinin kanser olmas\u0131 d\u00fc\u015f\u00fcn\u00fclemez. Tam tersine bu nod\u00fcllerde kanser olma olas\u0131l\u0131\u011f\u0131 son derece d\u00fc\u015f\u00fckt\u00fcr. Yani ameliyat gerektiren tiroid nod\u00fcl\u00fc say\u0131s\u0131 \u00e7ok azd\u0131r. Tiroid nod\u00fcllerinin tedavisinde ameliyat karar\u0131 verebilmek i\u00e7in h\u00fccre al\u0131n\u0131p patologlar taraf\u0131ndan incelenmesi gerekmektedir (\u0130nce i\u011fne aspirtasyon biyopsisi). Bu y\u00f6ntemle tiroid nod\u00fcllerinin %80\u2019ninin ameliyat olmas\u0131na gerek olmad\u0131\u011f\u0131 saptanmaktad\u0131r. Hastalar\u0131n %20\u2019sine ise ameliyat karar\u0131 \u00e7\u0131kmaktad\u0131r. Buna ra\u011fmen ameliyat olan hastalar\u0131n %80\u2019ninde herhangi bir kanser bulgusu saptanmamaktad\u0131r, yani bu hastalara gereksiz ameliyat uygulanmaktad\u0131r. Son y\u0131llarda yap\u0131lan \u00e7al\u0131\u015fmalarda tiroid nod\u00fcllerinin PET sintigrafisi ile de\u011ferlendirilmesiyle gereksiz yap\u0131lan tiroid ameliyatlar\u0131n\u0131n %64 oran\u0131nda azalt\u0131labilece\u011fi ortaya \u00e7\u0131km\u0131\u015ft\u0131r. Unutulmamal\u0131d\u0131r ki tiroid ameliyat\u0131n\u0131n her ameliyatta oldu\u011fu gibi ciddi t\u0131bbi riskleri ve ciddi mali sonu\u00e7lar\u0131 vard\u0131r. Yan tarafta izlenen PET sintigrafisinde tiroid nod\u00fcl\u00fc pozitif olan hastan\u0131n yap\u0131lan ameliyattan sonra tiroid papiller kanseri oldu\u011fu ortaya \u00e7\u0131km\u0131\u015ft\u0131r.<br \/>\n (Cerrahpa\u015fa T\u0131p Fak\u00fcltesi N\u00fckleer T\u0131p Anabilim Dal\u0131 Ar\u015fivi)<\/p>\n<h3>Avrupadaki hekimler aras\u0131nda nod\u00fcler guatr tedavisindeki farkl\u0131l\u0131klar;<\/h3>\n<p>Yap\u0131lan bir \u00e7al\u0131\u015fmada, Avrupadaki hekimlerin aras\u0131nda nod\u00fcler guatr\u0131n te\u015fhis ve tedavisinde b\u00fcy\u00fck farkl\u0131l\u0131klar oldu\u011funu ortaya koymu\u015ftur.<br \/>\n Hollandada yap\u0131lan bir \u00e7al\u0131\u015fmada Avrupada, 22 \u00fclkenin hekimlerine bir anket formu g\u00f6nderilmi\u015ftir. Anket formunda hekimlere nod\u00fcler guatr tan\u0131s\u0131n\u0131 ve tedavisini nas\u0131l yapt\u0131\u011f\u0131 sorulmu\u015ftur. Bu anket \u00e7al\u0131\u015fmas\u0131n\u0131n sonucunda hekimlerin sadece % 10\u2019u cerrahi tedavi \u00f6nerirken %90\u2019n\u0131 cerrahi tedavi d\u0131\u015f\u0131 y\u00f6ntemler \u00f6nermi\u015flerdir. Cerrahi tedavi \u00f6neren hekimlerin\u2019de mutlaka bir gerek\u00e7elerinin oldu\u011fu ortaya \u00e7\u0131kmaktad\u0131r. Bu gerek\u00e7elerin ba\u015f\u0131nda yap\u0131lan aspirasyon biyopsisinde kanser \u015f\u00fcphesinin olmas\u0131 gelmektedir. Te\u015fhis y\u00f6ntemi olarak hekimlerin %85\u2019i ultrason, %75\u2019i sintigrafi ve %70\u2019i de her ikisini birden kullanmaktad\u0131r. Sintigrafide so\u011fuk nod\u00fcl tespit edilmesi halinde hekimlerin %95\u2019i aspirasyon biyopsisi istemektedir. Yap\u0131lan \u00e7al\u0131\u015fmada te\u015fhis ve tedavide Avrupada \u00fclkeden \u00fclkeye farkl\u0131l\u0131klar g\u00f6sterdi\u011fini ortaya koymu\u015ftur.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tiroit nod\u00fclleri s\u0131kl\u0131\u011f\u0131 toplumdan topluma de\u011fi\u015fim g\u00f6stermekle birlikte hassas ultrasonografilerin kullan\u0131ma girmesiyle belirgin bi\u00e7imde artm\u0131\u015ft\u0131r. \u00d6zellikle bizim \u00fclkemizdeki gibi iyot eksikli\u011fi \u00e7ekilen toplumlarda bu oran %50-60\u2019lara varmaktad\u0131r.Nodul Bir ba\u015fka deyi\u015fle her 100 ki\u015fiden 50-60\u2019\u0131nda tiroid nod\u00fclleri g\u00f6r\u00fclmektedir. Bu tiroid nod\u00fcllerinin hepsinin ameliyat olmas\u0131 veya hepsinin kanser olmas\u0131 d\u00fc\u015f\u00fcn\u00fclemez.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":18,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_robots_primary_cat":"","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","footnotes":""},"class_list":["post-91","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/pages\/91","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/comments?post=91"}],"version-history":[{"count":1,"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/pages\/91\/revisions"}],"predecessor-version":[{"id":563,"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/pages\/91\/revisions\/563"}],"up":[{"embeddable":true,"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/pages\/18"}],"wp:attachment":[{"href":"https:\/\/www.leventkabasakal.com\/en\/wp-json\/wp\/v2\/media?parent=91"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}