Completion thyroidectomy of well-differentiated thyroid cancer - a prospective, randomised study

Area of Science:

• Endocrinology
• Surgical Oncology
• Nuclear Medicine

Background:

• Completion thyroidectomy is necessary for postoperatively diagnosed papillary or follicular thyroid cancer after subtotal thyroidectomy.
• Intraoperative gamma probe use can aid re-operation in these cases.
• This study evaluates the benefits of a hand-held gamma detector in completion thyroidectomy for well-differentiated thyroid cancer (WTC).

Purpose of the Study:

• To assess the efficacy of intraoperative gamma probe use during completion thyroidectomy.
• To compare the radicality of thyroid cancer resection with and without a gamma detector.
• To evaluate the impact of gamma probe use on postoperative complication rates.

Main Methods:

• 75 patients with WTC underwent total re-thyroidectomy.
• 43 patients (Group I) used a hand-held gamma probe (Navigator GPS) intraoperatively.
• 32 patients (Group II) were re-operated without a gamma probe.
• Thyroglobulin (Tg) levels and I(131) uptake via total body scanning (TBS) were used to estimate resection radicality.

Main Results:

• Lower average thyroglobulin (Tg) levels (3.32 vs. 4.58 ng/mL, p=0.021) and iodine uptake (6.29 vs. 7.31 ng/mL, p=0.187) were observed in the gamma probe group (Group I).
• Postoperative complication frequencies were comparable between the gamma probe (Group I) and non-gamma probe (Group II) groups (p=0.109).

Conclusions:

• Intraoperative gamma detector use can enhance the radicality of completion thyroidectomy for incomplete primary resections.
• Experienced surgeons achieve comparable outcomes with or without gamma detector assistance.
• Gamma probe use shows potential benefits in improving resection completeness.