Clinical Analysis Of Reoperation For 222 Cases Of Differentiated Thyroid Cancer

Objective: To analyze the causes of reoperation for differentiated thyroid cancer(DTC),and summarize the strategies for reducing reoperationMethods: To retrospectively analyze 222 patients with differentiated thyroid cancer who underwent reoperation in department of endocrinology and breast surgery of the First Affiliated Hospital of Chongqing Medical University from January 2013 to December 2017.According to the clinical evaluation before initial operation,the patients were divided into cN0 differentiated thyroid cancer(DTC cN0),cN1 differentiated thyroid cancer(DTC cN1),differentiated thyroid cancer of unknown(DTC unknown)and benign thyroid lesions,follow-up and statistics reoperation time,initial operation mode,reoperation area,and analyze the causes of reoperation.Results: In this study,there were 219 cases of papillary thyroid carcinoma(PTC)and 3 cases of follicular thyroid cancer(FTC).There were 63 cases(28.4%)of DTC cN0,48 cases(21.6%)of DTC cN1,27cases(12.2%)of DTC unknown and 84 cases(37.8%)of benign thyroid lesions in the first operation.Total thyroidectomy plus central lymph nodedissection and total thyroidectomy were performed in 40 cases(63.5%)in DTC cN0 group and total thyroidectomy plus central and lateral lymph node dissection in 39 cases(81.2%)in DTC cN1 group for the primary surgery.The time span of reoperation for benign thyroid lesions was all within 1 year,13 months(range 0.5-132 months)for DTC cN0,and 12months(range 4-180 months)for DTC cN1.The main reason for the reoperation of DTC cN0 and DTC cN1 was the metastasis of the lateral lymph nodes.The most frequency area of DTC cN0 was ipsilateral III area and was up to 59.7%,while DTC cN1 was 50.0% for ipsilateral II area.Conclusion: Preoperative evaluation of the first operation for thyroid benign lesions but postoperative pathological examination suggest DTC may soon lead to reoperation,and lateral lymph node metastasis and incomplete dissection in first operation for DTC are important reasons for reoperation.