Bender Omer, Karyagar Savas, Levent Balci Fatih, Yuney Enis, Kamali Sedat, Ozpacaci Tevfik, Mulazimoglu Mehmet, Uyanik Ercan, Karyagar Sevda S, Sari Yavuz Selim
Department of Surgery, Okmeydani Training and Research Hospital, Sisli- Istanbul, Turkey.
Hell J Nucl Med. 2009 May-Aug;12(2):138-41.
Patients undergoing partial thyroidectomy for benign diseases may need re-operation if differentiated thyroid carcinoma (DTC) is detected on histopathology. The aim of this study was to determine if using gamma probe during the above surgery in a procedure called: gamma probe completion thyroidectomy (GPCT) could support the diagnosis of DTC tissue and offer an advantage in the surgical treatment of DTC patients. We have studied 100 patients who after bilateral subtotal thyroidectomy for benign disease in several hospitals, were found to have DTC histopathologically and referred to our clinic for subsequent re-operation. Of these, 50 underwent conventional completion thyroidectomy (Group I) and 50 underwent GPCT (Group II). We compared retrospectively Group I and Group II in terms of volume of residual thyroid tissue, thyroid stimulating hormone (TSH) values, complication rates and incidence of tumor found in the residual thyroid. Our results showed that one month postoperatively, TSH was significantly higher in Group II (P<0.001). Volumes of residual thyroid were also significantly less in Group II (P<0.000). Complications and the incidence of tumor cells found in the residual thyroid tissue between the groups were not statistically different (P>0.05). In conclusion, GPCT in patients with DTC significantly increased the success of this operation in localizing and removing residual thyroid tissue.
因良性疾病接受部分甲状腺切除术的患者，如果在组织病理学检查中发现分化型甲状腺癌（DTC），可能需要再次手术。本研究的目的是确定在上述手术中使用γ探测仪进行γ探测仪辅助甲状腺全切术（GPCT）是否有助于诊断DTC组织，并在DTC患者的手术治疗中提供优势。我们研究了100例患者，这些患者在几家医院因良性疾病接受双侧甲状腺次全切除术后，经组织病理学检查发现患有DTC，并被转诊至我院进行后续再次手术。其中，50例接受了传统甲状腺全切术（第一组），50例接受了GPCT（第二组）。我们回顾性比较了第一组和第二组在残余甲状腺组织体积、促甲状腺激素（TSH）值、并发症发生率以及残余甲状腺中发现肿瘤的发生率方面的情况。我们的结果显示，术后1个月，第二组的TSH显著更高（P<0.001）。第二组的残余甲状腺体积也显著更小（P<0.000）。两组之间的并发症以及残余甲状腺组织中发现肿瘤细胞的发生率无统计学差异（P>0.05）。总之，DTC患者的GPCT显著提高了该手术在定位和切除残余甲状腺组织方面的成功率。
