Analysis of reoperation with differentiated thyroid cancer / 中国综合临床

ABSTRACT

Objective To discuss the main causes, necessity and strategy of reoperation in patients with differentiated thyroid cancer. Methods The clinical data of 124 patients with thyroid cancer who needed reoperation from 2000 to 2010 were analyzed retrospectively. Results In the 124 patients with thyroid cancer required for reoperation, 75 cases were misdiagnosed as benign thyroid tumor and previously received local nodulectomy or subtotal lobectomy, in which the extent of resection was not enough; in 39 cases, the first time surgical modality were unsuitable, of which 27 cases with cervical lymph node metastasis were not performed cervical lymph node dissection, and 12 cases with cervical lymph node metastasis cancer were only performed lymph node biopsy, and the diagnosis of thyroid cancer was ignored. 10 cases suffered reoperation because of failure to diagnosis thyroid cancer by quick pathologic diagnosis. The rate of residual cancer was 50% (62/124) by final pathologic diagnosis,and the rate of complication was 4.03% (5/124). Conclusion Misdiagnosis of thyroid cancer as benign thyroid tumor is the main cause of reoperation. Reoperation is necessary for those patients who received nonstandardized operation. The key points of avoiding reoperation are to improve cognitive level of operator for thyroid cancer, to emphasize the routine application of quick pathologic diagnosis during operation of thyroid and select the best suitable surgical modality.