Clinical Analysis Of Reoperation Of Papillary Thyroid Carcinoma

Object:To analyze and explore the causes and countermeasures of reoperation of papillary thyroid carcinoma.Methods:A retrospective study, which includes 35 cases with reoperation of papillary thyroid carcinoma who were hospitalized in Shandong Province Hospital during the last three years.Results:The reoperation due to preoperative misdiagnosis was in 16 cases (45.7%), and postoperative pathology showed the residual cancer rate was 56.3%(9/16). The re-operation due to tumor recurrence or metastasis after first operation was in 16 cases (45.7%). Among them,6 cases were within one year was, of which 4 cases were caused by non-standard operation for the first time.And 10 cases were above one year, of which 2 cases were caused by non-standard operation for the first time. The reoperation due to other causes was in 3 cases (8.6%). Among all patients with reoperation of thyroid cancer, total resection of affected side lobe and isthmus and subtotal resection of contralateral lobe was performed at least, and 11 cases underwent total thyroidectomy. We probed the lymph nodes around the cervical vagina vasorum conventionally, and took selective or modified neck dissection according to the results of preoperative examination and intraoperative frozen section.Postoperative complications occurred in 5 patients (14.3%). Among them, two cases were hoarseness and both recovered after 5 months after the surgy; three cases were convulsions and alleviated after calcium treatment. All 35 cases were followed up for 2 to 36 months by the way of telephone or regularly review and no deaths were found. In addition to two cases with palliative resection of thyroid cancer, there was no recurrence or metastasis.Conclution:Misdiagnosis, tumor recurrence and metastasis are the main reasons for reoperation of thyroid papillary carcinoma. To improve surgeon's awareness of thyroid cancer and emphasize the conventional application of rapid intraoperative frozen section examination in thyroid surgery, choose the appropriate surgical method and do close postoperative follow-up is the key to avoid reoperation, improve the quality of life and survival of papillary thyroid carcinoma patients.