Nechaĭ O P, Larin O S, Cheren'ko S M, Sheptukha S A, Smoliar V A, Zolotar'ov P O
Klin Khir. 2012 Jul(7):9-11.
Incidence of unexpected diagnosis of thyroid carcinoma among operations on benign thyroid surgical diseases (nodular goiter and Graves' disease) was studied in 608 patients within 2008-2009 years in specialized clinic of endocrine surgery. In 56 (9.2%) patients the "incidental" thyroid carcinoma including 43 (77%) - papillary microcarcinoma were diagnosed in histological investigations. In 10 (18%) patients which were performed within the first postoperative week. Repeated surgery demonstrates increased risk of complication (damage of parathyroid glands, recurrent laryngeal nerves and other anatomic structures of neck) considering less favoring conditions for secondary operations, it is worth to implement wider indications to frozen section, radical primary operation (total thyroidectomy at multi-nodular bilateral goiter and Graves' disease), and also maximal complete examination prior to surgery.
2008 - 2009年期间,在内分泌外科专科医院对608例接受良性甲状腺外科疾病(结节性甲状腺肿和格雷夫斯病)手术的患者进行研究,以探讨意外诊断为甲状腺癌的发生率。在56例(9.2%)患者中,经组织学检查诊断出“意外”甲状腺癌,其中43例(77%)为乳头状微小癌。在术后第一周内进行手术的10例(18%)患者中。考虑到二次手术的条件较差,再次手术显示出并发症(甲状旁腺、喉返神经和颈部其他解剖结构损伤)风险增加,因此值得扩大冰冻切片的适应证、实施根治性初次手术(多结节双侧甲状腺肿和格雷夫斯病行全甲状腺切除术),并在手术前进行最大程度的全面检查。