Alternative surgery for low grade thyroid malignancies
Journal
Journal of the Formosan Medical Association
Journal Volume
108
Journal Issue
6
Pages
508-512
Date Issued
2009
Author(s)
Abstract
Traditional surgery for thyroid nodule is usually performed via anatomic localization of the recurrent laryngeal nerve (RLN), inferior thyroid artery and parathyroid glands (PTGs) initially. Due to the RLN constantly lying beneath the thyroid gland and low grade malignancy of well-differentiated thyroid cancer (WDTC), it is not necessary to find the nerve initially and impossible to make too deep resection. From May 1998 to July 2005, 33 patients with WDTC underwent total thyroidectomy along the capsule with or without modified radical neck dissection without identifying the RLN and PTGs initially. The isthmus, capsular vessels and Berry's ligament were cut from above and the RLN could be found lying in the surgical bed. The PTGs could be found when the thyroid was retracted medially and removed. The patients were followed-up until December 2007. The safety of the method, complications and clinical outcomes were evaluated. For the patients with WDTC, only one patient (3%) had transient vocal palsy. Incidental parathyroidectomy was found in six (18%) patients, resulting in two (6%) with temporary and two (6%) with permanent hypocalcemia. Only one 86-year-old woman died of disease recurrence; the other patients remained disease-free. Total thyroidectomy for WDTC without identifying the RLN and PTGs initially is an easy and safe alternative method. ?2009 Elsevier & Formosan Medical Association.
Subjects
Hypocalcemia; Total thyroidectomy; Vocal palsy
SDGs
Other Subjects
adolescent; adult; aged; article; berry ligament; cancer recurrence; clinical article; female; follow up; human; hypocalcemia; ligament; male; parathyroid gland; parathyroidectomy; recurrent laryngeal nerve; safety; surgical anatomy; surgical technique; thyroid cancer; thyroidectomy; treatment outcome; vocal cord paralysis; well differentiated thyroid cancer
Publisher
Scientific Communications International Ltd
Type
journal article