[Re-operation for thyroid carcinoma patients who received nonstandard operation]

To analyze the reasons for re-operation and living condition of thyroid carcinoma patients who received second operation, and to formulate indications for selecting re-operation candidates and operation types.

One hundred and eleven thyroid carcinoma patients were retrospectively summarized. All patients received re-operation after thyroidectomy from 1986 to 1997. The post operative follow-up data were analyzed statistically.

Pathological results confirmed there were 67.6% (75/111) cases with residual tumor. The incidence rate of post-operative complications was 2.7%, including 0.9% (1/111) recurrent laryngeal nerve injury. The sensitivity of residual carcinoma detection by CT scan before operations was 80.0% (28/35), with the positive predictive value of 87.5% (28/32). The recurrence rate within 3 years was 11.7% (13/111), with a local control rate of 88.3% (98/111). The recurrence rate within 5 years was 14.4% (16/111), with a local control rate of 85.6% (95/111). Life table was adopted to calculate living rates. The accumulated 5-year and 10-year living rates of re-operated thyroid carcinoma patients were 95.0% and 93.2% respectively. Analysis of Cox Regression showed that carcinoma recurrence influenced survival conditions significantly.

The residual rate of re-operated patients with thyroid carcinoma was relatively higher, so a cautious re-operation was necessary. CT scan has a relatively higher positive predictive rate in detecting residual carcinoma, so it is necessary for screening right candidates for re-operation. Recurrence was the main factor that influenced patients' survival. So making proper indications, according to which to select patients who need re-operations will decrease the incidence of unnecessary operations.