open access
Completion thyroidectomy of well-differentiated thyroid cancer — a prospective, miserandomised study
open access
Abstract
thyroidectomy. Re-operation with a gamma probe can be particularly useful in these patients.
The aim of this study was to evaluate the benefits of using an intraoperative hand-held gamma detector during completion thyroidectomy
in patients with well-differentiated thyroid cancer (WTC).
Material and methods: 75 patients with WTC qualified for total re-thyroidectomy. In 43 patients, Group I (Nav), a hand-held gamma
probe (Navigator GPS) was used intraoperatively. 32 patients were re-operated without the gamma probe (Group II). In Group I, thyroid
remnants were removed based on counted gamma signals. To estimate the radicality of reoperation in both groups, thyroglobulin (Tg)
levels were determined and total body scanning (TBS) — I131 uptake — was performed.
Results: Total thyroidectomy with central lymphadenectomy was performed in 75 cases. The average level of Tg and iodine uptake after
radicalisation was lower in Group I (Nav) than in Group II (3.32 ± 2.09 v. 4.58 ± 2.5 ng/mL, respectively, for Tg [p = 0.021] and 6.29 ±
3.38 v. 7.31 ± 2.29 ng/mL, respectively, for iodine uptake [p = 0.187]). Additionally, the frequency of postoperative complications was
comparable, the difference in both groups was not significant, despite the use of the gamma probe (p = 0.109).
Conclusions: The intraoperative use of a hand-held gamma detector can help to improve the radicality of a completion thyroidectomy
procedure after an incomplete primary thyroid resection, but the results of this procedure in the hands of an experienced surgeon are
comparable whether or not the gamma detector is used. (Endokrynol Pol 2013; 64 (5): 335–339)
Abstract
thyroidectomy. Re-operation with a gamma probe can be particularly useful in these patients.
The aim of this study was to evaluate the benefits of using an intraoperative hand-held gamma detector during completion thyroidectomy
in patients with well-differentiated thyroid cancer (WTC).
Material and methods: 75 patients with WTC qualified for total re-thyroidectomy. In 43 patients, Group I (Nav), a hand-held gamma
probe (Navigator GPS) was used intraoperatively. 32 patients were re-operated without the gamma probe (Group II). In Group I, thyroid
remnants were removed based on counted gamma signals. To estimate the radicality of reoperation in both groups, thyroglobulin (Tg)
levels were determined and total body scanning (TBS) — I131 uptake — was performed.
Results: Total thyroidectomy with central lymphadenectomy was performed in 75 cases. The average level of Tg and iodine uptake after
radicalisation was lower in Group I (Nav) than in Group II (3.32 ± 2.09 v. 4.58 ± 2.5 ng/mL, respectively, for Tg [p = 0.021] and 6.29 ±
3.38 v. 7.31 ± 2.29 ng/mL, respectively, for iodine uptake [p = 0.187]). Additionally, the frequency of postoperative complications was
comparable, the difference in both groups was not significant, despite the use of the gamma probe (p = 0.109).
Conclusions: The intraoperative use of a hand-held gamma detector can help to improve the radicality of a completion thyroidectomy
procedure after an incomplete primary thyroid resection, but the results of this procedure in the hands of an experienced surgeon are
comparable whether or not the gamma detector is used. (Endokrynol Pol 2013; 64 (5): 335–339)
Keywords
well-differentiated thyroid cancer; completion thyroidectomy; gamma probe; iodoradiotherapy


Title
Completion thyroidectomy of well-differentiated thyroid cancer — a prospective, miserandomised study
Journal
Issue
Article type
Original paper
Pages
335-339
Published online
2013-11-01
Page views
2204
Article views/downloads
3312
DOI
10.5603/EP.2013.0014
Bibliographic record
Endokrynol Pol 2013;64(5):335-339.
Keywords
well-differentiated thyroid cancer
completion thyroidectomy
gamma probe
iodoradiotherapy
Authors
Monika Proczko
Tomasz Stefaniak
Krzysztof Sworczak
Jarosław Kobiela
Andrzej Jacek Łachiński
Pieter Stepaniak
Zbigniew Śledziński