Operation Method for Well-Differentiated Thyroid Cancer
Journal of the Korean Surgical Society
;
: 335-343, 2000.
Article
in Korean
| WPRIM
| ID: wpr-103414
ABSTRACT
PURPOSE:
The treatment of choice for well-differentiated thyroid cancer is surgical excision. However, the operation method is still controversial. Also, the operation method has been changing gradually. Thus, we reviewed the records of patients with well-differentiated thyroid cancer who had received operations in our hospital to assess the trend in surgical procedure, and to determine the proper procedure, method, considering both recurrence and complications.METHODS:
We retrospectively analyzed the cases of 452 patients with differentiated thyroid cancer who had received operations from January 1989 to December 1998. We divided the 10 years into two periods; period I was from 1989 to 1993 (254 patients) and period II was from 1994 to 1998 (198 patients). We analyzed recurrences and complications according to the operation method, including neck lymph-node dissection. The incidences and locations of lymph- node metastasis were taken into account, too. The statistical analysis was done by using the Fisher's exact test.RESULTS:
In period I, 147 patients (58%) received a total thyroidectomy, and in period II, all patients received total thyroidectomy. In period I, 24 patients (9.4%) had a recurrence, and in period II, 13 patients (6.6%) had a recurrence. In period I, 55 patients (21.7%) had postoperative hypoparathyr oidism, and in period II, 38 patients (19.2%) had postoperative hypoparathyroidism. In period I, 15 patients (5.9%) had postoperative hoarseness, and in period II, 7 patients (3.5%) had postoperative hoarseness. Two hundred eighty-one patients (62.2%) had lymph-node metastasis, and the anterior neck region was the most common site of metastasis (60.2%).CONCLUSION:
In the operation method for differentiated thyroid cancer, the trend is toward a total thyroidectomy away from a lobectomy. Also, a skillful and experienced surgeon can reduce the incidence of postoperative complications. Thus the best operation method for differentiated thyroid cancer is a total thyroidectomy, including a preventive anterior-neck lymph-node dissection, which is done by a skillful and experienced surgeon.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Postoperative Complications
/
Recurrence
/
Thyroid Gland
/
Thyroidectomy
/
Thyroid Neoplasms
/
Hoarseness
/
Incidence
/
Retrospective Studies
/
Hypoparathyroidism
/
Neck
Type of study:
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Surgical Society
Year:
2000
Type:
Article
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