[Contribution of peroperative ultrasonography]

Area of Science:

• Endocrinology
• Surgical Oncology
• Medical Imaging

Background:

• Ultrasonography is a key tool for thyroid gland morphological analysis but can yield false negatives.
• Residual nodules post-thyroid surgery can lead to recurrence.
• Systematic two-finger palpation by surgeons is recommended to avoid recurrence.

Purpose of the Study:

• To evaluate the effectiveness of intraoperative ultrasonography compared to preoperative ultrasonography and intraoperative palpation.
• To determine the best methods for avoiding residual thyroid nodules after surgery.

Main Methods:

• A randomized prospective study was conducted.
• The study compared intraoperative ultrasonography, preoperative ultrasonography, and intraoperative palpation.
• The assessment focused on identifying residual nodules and evaluating parenchyma remaining.

Main Results:

• Intraoperative ultrasonography is particularly valuable for equivocal preoperative findings like "heterogeneous parenchyma" or "hypoechogenic areas".
• Both preoperative and intraoperative ultrasonography effectively visualize remaining thyroid parenchyma in multinodular goiters.
• Intraoperative exploration, using palpation, ultrasound, or both, appears optimal for preventing residual nodules.

Conclusions:

• Intraoperative ultrasonography and palpation are crucial for comprehensive thyroid gland assessment during surgery.
• Combining palpation and intraoperative ultrasound offers the most reliable method to prevent residual nodules and subsequent recurrence.
• Systematic intraoperative evaluation minimizes the risk of missed nodules and improves surgical outcomes.