What do we leave behind after neartotal and subtotal thyroidectomy: Just the tissue or the disease?

Karakoyun R., Bülbüller N., Koçak S., Habibi M., Gündüz U., Erol B., ...Daha Fazla

International Journal of Clinical and Experimental Medicine, cilt.6, sa.10, ss.922-929, 2013 (SCI-Expanded, Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 6 Sayı: 10
  • Basım Tarihi: 2013
  • Dergi Adı: International Journal of Clinical and Experimental Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.922-929
  • Anahtar Kelimeler: Multinodular goiter, Neartotal thyroidectomy, Residual tissue, Subtotal thyroidectomy, Total thyroidectomy
  • Ankara Üniversitesi Adresli: Evet

Özet

Selection of multinodular goiter (MNG) surgery procedure is stilll under discussion. Subtotal thyroidectomy (STT) and near total thyroidectomy (NTT) are preferred surgical procedures. However, it is uncertain whether the remnant tissue contains pathological findings or not after these procedures. We aimed to evaluate and comparison the pathologic findings in remnant tissue after NTT and STT. Thyroid tissue samples of 50 patients who underwent TT for MNG disease between January 2010 and August 2011 in our clinic were evaluated. Before the dissection of the thyroid tissue subtotal and near total margins were marked in both right and left lobes. After the resection of the specimen, the tissue was excised from the subtotal and near total margin marked during the surgery. The pathologic findings of the main tissue, the residual subtotal and near total tissues were evaluated and compared. All patients were followed-up 1 year. 43 (86%) females and 7 (14%) males with an average age of 50.5 (23-77) were included in the study. Incidental papillary thyroid cancer was detected in 5 patients (10%). Pathologic findings were present in 31 patients (62%) of subtotal residual tissue and 28 of the patients (56%) of near total residual tissue. Papillary micro carcinoma was detected in 3 (9.7%) of subtotal residual tissues and 2 (7.1%) of near total residual tissues. There is no significant difference between subtotal and near total tissues in terms of existence of pathological findings (p>0.05). There is no significant difference between the near total and subtotal residual tissues contralateral of dominant nodule (p>0.05). 2 of the patients (4%) had temporary hypocalcemia, 1 patient (2%) had seroma and 1 patient (2%) had recurrent laryngeal nerve injury. There are high rates of microscopic pathological findings on residual tissues both after STT and NTT. The near total and subtotal residual tissues contralateral to the large nodule also had high levels of pathologic findings.