Outcomc Of Reoperation For Thyroid Cancerxlinical Analysis Of62Cases

Objective:To analyze62cases of thyroid cancer surgery reasons, the first thyroid cancersurgery with pathologically confirmed the contralateral cancer recurrence relationship,thyroid cancer surgery for the first time whether lymph node dissection andre-pathologically confirmed lymph node metastasis relations, ultrasonographic findingsand pathologicalthe degree of compliance and accuracy of the results, reoperation,surgical lymph node dissection way.Methods：Retrospective analysis of General Surgery, the First Affiliated Hospital of DalianMedical University in20051,2012, to September1, total treated thyroid cancer surgeryin62patients, analysis of reoperation of62cases of thyroid cancer, thyroid cancer forthe first time to operate the way with pathologically confirmed the contralateral cancerrecurrence relations, thyroid cancer surgery for the first time whether to proceed withlymph node dissection and re-surgery and pathology confirmed the relationship betweenlymph node metastasis, ultrasound results and histologic findings Relevance andaccuracy, reoperation, surgical lymph nodecleaning.Results：1,62cases of thyroid cancer patients,11males and51females, male to femaleratio of1:5, aged20to66years old, average41.2years old.2, this group of patients, thyroid cancer, the first surgical approach to thyroid ipsilateralgland isthmus most of the+contralateral lobe resection, thyroid ipsilateral gland+isthmus+contralateral lobe times full resection major surgical procedures.Our hospitaland7cases were frozen misdiagnosed patients after conventional biopsy report forpapillary thyroid carcinoma, papillary thyroid micro-carcinoma, papillary carcinoma of the small membrane-inclusive, micro-invasive follicular carcinoma, minimal invasivefollicular thyroid cancer, medullary thyroid carcinoma.4, thyroid cancer for the first time surgical approach with pathological confirmed thecontralateral cancer recurrence by the chi-square test p=0.041there is a significantdifference, the extent of surgical resection, contralateral cancer recurrence rate.5, thyroid cancer surgery for the first time whether lymph node dissection andre-surgical pathology confirmed lymph node metastasis chi-square test, p=0.683wasno significant difference, for the first time surgical lymph node dissection andre-pathologically confirmed lymph node metastasis not.Doppler ultrasound, thyroidcancer swollen lymph nodes positive with pathological compliance by the chi-squaretest, p=0.0106significantly different clinical ultrasound lymph node-positive, lymphnode metastasis rate.Conclusions：Through the reoperation group of62cases of thyroid cancer clinical analysis, weshould strengthen the the preoperative thyroid Doppler ultrasound, CT, FNAC diagnosispopularity to enhance the diagnostic accuracy of intraoperative frozen histological,surgeons high index of suspicionmalignant intraoperative frozen for the the benignpathology to fully communicate with the pathologist exchange of views, for initialtreatment completely to avoid the re-operation of the line. Nodules surgery can not bediagnosed, should be at least the line, including the nodules lobectomy+isthmusectomies for the re-operation with ease. The first surgery, postoperativepathological type, preoperative ultrasound, CT, FNAC check again surgical optionsprovide a basis for:(1) papillary thyroid carcinoma micro and small and micro-invasivefollicular carcinoma initial surgery has been in the gland lobectomy to cancel the secondsurgery, reduce complications, ipsilateral partial nephrectomy surgery for the first time,re-operation should be selected total thyroidectomy;(2) intraoperative misdiagnosis ofmedullary thyroid carcinoma in order to reduce reoperation concurrent the occurrenceof disease feasible bilateral thyroidectomy central lymph node dissection;(3)undiagnosed pathology return of papillary carcinoma patients for surgery should beperformed thyroidectomy plus central lymph node dissection.(4) should be performedfor recurrence or lymph node metastasis in patients the thyroidectomy modified neckdissection.