Ahn Dongbin, Sohn Jin Ho, Kim Heejin
Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University, 807 Hogukno, Buk-gu, Taegu, 702-210, Republic of Korea,
World J Surg. 2014 Aug;38(8):1995-2001. doi: 10.1007/s00268-014-2504-4.
Identification and removal of small, non-palpable tumors located within previous surgical scar tissue is challenging and time consuming and may be associated with increased risk in patients with recurrent papillary thyroid carcinoma (PTC). The purpose of the present study was to present our surgeon-performed technique and to evaluate the usefulness of ultrasound-guided intratumoral indigo carmine injection (US-III) for intraoperative tumor localization in patients with recurrent PTC.
Sixteen patients with recurrent PTC in which tumors were <1.5 cm and not palpable were enrolled in this prospective study from January 2012 through March 2013.
The mean size of the target tumors was 0.85 cm (range 0.4-1.3 cm) on preoperative US. The average time required for the US-III procedure was 7.7 min (range 5-11 min). The mean volume of injected indigo carmine was 0.56 mL (range 0.3-1.0 mL); this injection expanded the tumors by a mean of 0.2 cm (23.5% increase compared with the initial tumor size; range 0.0-0.4 cm), increasing the mean size of the target tumors to 1.05 cm (range 0.5-1.5 cm). In 15 (93.8%) of the 16 patients, the recurrent tumors were successfully removed with the aid of US-III. No complications occurred in any of the patients as a result of the US-III or subsequent surgeries.
US-III is a safe and effective technique that can be performed by the surgeon for the intraoperative localization of small non-palpable tumors within previous scar tissue in patients with recurrent PTC.
识别并切除位于既往手术瘢痕组织内的不可触及的小肿瘤具有挑战性且耗时，对于复发性乳头状甲状腺癌（PTC）患者而言，这可能会增加风险。本研究的目的是介绍我们外科医生实施的技术，并评估超声引导下瘤内靛胭脂注射（US-III）在复发性PTC患者术中肿瘤定位的实用性。
2012年1月至2013年3月，16例复发性PTC患者纳入本前瞻性研究，这些患者的肿瘤<1.5 cm且不可触及。
术前超声显示，目标肿瘤的平均大小为0.85 cm（范围0.4 - 1.3 cm）。US-III操作平均所需时间为7.7分钟（范围5 - 11分钟）。靛胭脂平均注射量为0.56 mL（范围0.3 - 1.0 mL）；该注射使肿瘤平均增大0.2 cm（与初始肿瘤大小相比增加23.5%；范围0.0 - 0.4 cm），目标肿瘤平均大小增至1.05 cm（范围0.5 - 1.5 cm）。16例患者中有15例（93.8%）借助US-III成功切除复发性肿瘤。因US-III或后续手术，所有患者均未出现并发症。
US-III是一种安全有效的技术，外科医生可用于复发性PTC患者术中定位既往瘢痕组织内不可触及的小肿瘤。
