Dalcı Kubilay, Topal Ugur, Unal Ayse Gizem, Eray İIsmail Cem, Yalav Orcun, Guuney Isa Burak, Sakman Gurhan
Ann Ital Chir. 2020;91:166-172.
The aim of this study is to share the efficacy of the radionuclide occult lesion localization (ROLL) technique in secondary neck exploration in patients who had undergone neck exploration due to thyroid or parathyroid pathology and to share our clinical experience.
Data of 25 patients who underwent secondary neck exploration for recurrent thyroid cancer and parathyroid adenoma between January 2016 and December 2018 at the General Surgery Clinic of Balcalı Hospital, Çukurova University Faculty of Medicine were collected retrospectively. On the operation day, 0.5 mCi Tc-99m macroaggregate albumin was injected into the lesion under ultrasound guidance (USG). Nerve monitoring was used in all patients.
Twenty-five patients (21 females, 4 males) were included in the study. The mean age of the patients was 54.5 (24-79) years. Five patients were operated for parathyroid adenoma, 6 patients for papillary cancer after subtotal thyroidectomy, 13 patients for papillary cancer recurrence, 2 patients for medullary cancer recurrence, 2 patients for papillary cancer cervical lymph node metastasis and 1 patient for anaplastic cancer recurrence.Mean operative time was 100.6 min (60-160 min). Two patients had transient hypocalcemia and no other complications were seen. Parathyroid hormone (PTH) levels in patients with hyperparathyroidism, Thyroglobulin (Tg) levels in patients with recurrent papillary cancer, were significantly lower than preoperative levels (p<0.05).
We believe that ROLL technique reduces the complication rate by decreasing dissection time and width. We recommend using it for thyroid cancer and parathyroid redo surgery.
Parathyroid redo surgery, Radioguided surgery, Thyroid cancer.
本研究旨在分享放射性核素隐匿性病变定位（ROLL）技术在因甲状腺或甲状旁腺疾病接受过颈部探查的患者二次颈部探查中的疗效，并分享我们的临床经验。
回顾性收集2016年1月至2018年12月在Çukurova大学医学院Balcalı医院普通外科门诊因复发性甲状腺癌和甲状旁腺腺瘤接受二次颈部探查的25例患者的数据。手术当天，在超声引导下向病变内注射0.5 mCi的锝-99m聚合白蛋白。所有患者均使用神经监测。
25例患者（21例女性，4例男性）纳入研究。患者的平均年龄为54.5（24 - 79）岁。5例患者因甲状旁腺腺瘤接受手术，6例患者因甲状腺次全切除术后乳头状癌接受手术，13例患者因乳头状癌复发接受手术，2例患者因髓样癌复发接受手术，2例患者因乳头状癌颈部淋巴结转移接受手术，1例患者因未分化癌复发接受手术。平均手术时间为100.6分钟（60 - 160分钟）。2例患者出现短暂性低钙血症，未观察到其他并发症。甲状旁腺功能亢进患者的甲状旁腺激素（PTH）水平、复发性乳头状癌患者的甲状腺球蛋白（Tg）水平均显著低于术前水平（p<0.05）。
我们认为ROLL技术通过减少解剖时间和范围降低了并发症发生率。我们建议在甲状腺癌和甲状旁腺再次手术中使用该技术。
甲状旁腺再次手术；放射性引导手术；甲状腺癌
