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KMID : 0371320130850030104
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Journal of the Korean Surgical Society
2013 Volume.85 No. 3 p.104 ~ p.108
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On-site ultrasound-guided localization for impalpable nodal recurrences in papillary thyroid carcinoma patients
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Kim Kuk-Jin
Kim Bup-Woo
Lee Yong-Sang
Chang Hang-Seok
Park Cheong-Soo
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Abstract
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Purpose: The cervical lymph nodes are the most common sites of locoregional recurrence in patients with papillary thyroid carcinoma (PTC). Accurate tumor localization is important for the successful removal of impalpable recurrences in the cervical lymph nodes. We evaluated the benefits of ultrasound-guided localization (UGL) performed by a single surgeon on site. Methods: Of 53 PTC patients who underwent reoperation for impalpable nodal recurrences, 32 (group 1) were assessed only using preoperative imaging, while 21 (group 2) were additionally evaluated by on-site UGL performed by the operating surgeon. Postoperative outcomes were compared between the two groups. Results: Operation times were significantly shorter (P < 0.001) and the mean size of the resected lymph nodes were smaller (P = 0.013) for group 2 patients. More lymph nodes were identified and resected in group 1 (3.56 vs. 3.19), but the rate of positive lymph nodes was significantly higher in group 2 (P < 0.001). There were no differences between the two groups in terms of resection success rate, complication rate, and postoperative hospital stay. During a mean follow-up period of 27.6 months, 52 patients (98.1%) showed no evidence of recurrence on routine ultrasound, and serum thyroglobulin concentrations remained < 1 ng/mL in 49 patients (92.5%). Conclusion: On-site UGL performed by the operating surgeon is useful for accurate resection of impalpable nodal recurrences in PTC patients.
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KEYWORD
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On-site ultrasound, Localization, Impalpable nodal recurrences, Papillary thyroid carcinoma
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