ABSTRACT
Objective To discuss the preventive strategy of complications in reoperation of differentiated thyroid carcinoma (DTC).Method Clinical data of 114 patients with DTC who needed reoperation because of recurrence or inadequate operation were reviewed retrospectively.The reoperations included total thyroidectomy for 101 cases,lobectomy for 13 cases,central compartment neck dissection for 94 cases,and lateral neck dissec tion for 65 cases.Results 8 cases (8.77％) suffered from temporary RLN injury,one patient (0.88％) has permanent nerve palsy.Nerve dysfunction recovered after reoperation in 4 cases who had suffered from recurrent laryngeal nerve palsy in previous operations.Transient hypoparathyroidism occured in 10 patients (8.77％),and per manent hypoparathyroidism happened to 2 patients (1.75％).Conclusion For patients undergoing reoperation,detailed preoperative examination,proper operative approach,meticulous dissection on the thyroid capsule,visual identification of RLN followed anatomic landmark and intraoperative nerve monitoring (IONM) are key factors to reduce complications in reoperation of DTC.
ABSTRACT
Objective To investigate the expression of sodium iodide symporter (NIS ) mRNA in differentiated thyroid Carcinoma (DTC)and further explore its value in clinical diagnosis and therapy of DTC. Methods The expression of NIS mRNA was detected and analyzed in 21 nodular goiter and 45 cases of DTC (including 35 cases of papillary thyroid carcinoma and 10 cases of follicular thyroid carcinoma)by using real-time fluorescent quantitative reverse transcription polymerase chain reaction (real-time RT-PCR).Results Compared with that in nodular goiter,the mRNA expression of NIS in DTC tissue was significantly decreased (P < 0.05 ). Moreover,the mRNA expression of NIS was significantly correlated with lymph node metastasis and AJCC stage, respectively.The expression of NIS mRNA in DTC with lymph node metastasis was significantly decreased compared with that in DTC without lymph node metastasis (P <0.05).In addition,the expression of NIS mRNA in Ⅱ-Ⅳstage DTC was significantly decreased compared with that in Ⅰ - Ⅱ stage DTC (P < 0.05 ).Conclusion Differential expression of NIS can provide evidence for individual 1 3 1 I therapy for DTC.