ABSTRACT
In recent years , the incidence of thyroid cancer has been increasing , and papillary thyroid microcarcinoma (PTMC) has become a major component in newly diagnosed thyroid cancers .Since the prognosis of PTMC is favorable ,new viewpoints in diagnosis and treatment of PTMC have been constantly put forward by new research .Therefore , diagnosis and treatment of PTMC has become one of the most popular topics in thyroid surgery .In this article , we discuss the hot issues in PTMC based on the 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer .
ABSTRACT
Objective To evaluate the effectiveness ,safety and prospect of ultrasound-guided radiofrequency ablation (RFA) in treatment of thyroid benign nodules .Methods We analyzed 153 patients with thyroid benign nodules from September 2015 to August 2016 treated by RFA at Department of Thyroid Surgery ,the First Affiliated Hospital of Zhengzhou University . One month later , we reviewed the thyroid functions after the operation , observed the changes of the nodules after 1 ,3 ,and 6 months ,calculated the volume reduction rate of the nodules , and analyzed the effectiveness of the treatment .Results After treatment ,the maximum diameter and volume of the nodules were significantly reduced in all the patients ( P<0 .05) .The patients' symptoms improved significantly without serious complications . Conclusion Ultrasound-guided RFA has obvious advantages such as fewer complications , less invasiveness , good safety , and definite effectiveness in treating thyroid benign nodules . Therefore ,it has promising prospects in clinical application .
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Objective To observe the curative effects of treatment with Octreotide for chylous leakage after neck dissection .Methods We enrolled 14 patients with intractable chylous fistula treated at the First Affiliated Hospital of Zhengzhou University for the study .The curative effects of Octreotide treatment were retrospectively reviewed .Results Out of 14 patients with intractable chylous fistula ,12 (12/14 ,86% ) were finally cured and had the drainage tube removed .The drainage volume of 7 patients (7/14 ,50% ) decreased significantly by over 50%the next day of Octreotide medication ,but decreased insignificantly in 4 patients (4/14 ,29% ) .Conclusion Octreotid is an alternative method in treatment for intactable chylous fistula because of a satisfactory curative effect in some of the patients .
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Objective To explore the characteristics and components of recurrent papillary thyroid cancer in patients with metabolic syndrome .Methods We retrospectively reviewed the information of the patients with recurrent papillary thyroid cancer after initial surgery during January 1st ,2010 and December 31st ,2015 in the First Affiliated Hospital of Zhengzhou University .We compared tumor size ,lymph node metastasis ,recurrence time and postoperative invasion rate in metabolic syndrome and non-metabolic syndrome groups . Results Totally 82 patients were included with 34 men and 48 women .There was no significant difference between patients with and those without metabolic syndrome grouped by the classic diagnosis approach .However ,the lymph node metastasis grade of recurrent papillary thyroid cancer patients who also suffered from at least two metabolic disorders ,was lower ,especially in women (P=0 .002) .Moreover ,patients with metabolic disorders had shorter recurrence time (Pdiabetes=0 .034 , Pdyslipidemia =0 .037 , PBMI =0 .004 , PMetS2 =0 .036) .Conclusion Papillary thyroid cancer patients with metabolic disorder ,especially with two or more components of metabolic syndrome and overweight and/or obesity ,may have an increasing risk of recurrence .
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Objective To evaluate the curative effects of endoscopic and open thyroidectomy for papillary thyroid microcarcinoma so as to explore the feasibility of endoscopic operation for papillary thyroid microcarcinoma . Methods We made a retrospective analysis of data of 98 cases of papillary thyroid microcarcinoma diagnosed pathologically between June 2016 and January 2017 in the First Affiliated Hospital of Zhengzhou University .All the patients were divided into two groups :52 in traditional operation group and 46 in endoscopic operation group . We analyzed the complications and the number of lymph nodes in the two groups . Results There was no significant difference in complications like voice hoarseness , hydroposia bucking and hypocalcemia between the two groups (P= 0 .6993 ,0 .9141 ,0 .5819 ,respectively) .Each patient had (5 .06 ± 3 .20) and (4 .80 ± 3 .19) lymph nodes in endoscopic operation group and traditional operation group ,respectively . No significant difference was found between the two groups (P=0 .6967) .Conclusion The traditional operation and endoscopic operation have similar curative effects for papillary thyroid microcarcinoma ,and the latter has better cosmetic effects .