Abstract:Objective:To study the choice of initial operative approach for thyroid nodule and the necessity of reoperation after local excision of differentiated thyroid cancer.
Methods :Clinical data of 138 patients with differentiated thyroid cancer after local tumor excision had reoperation at our hospital during a period of four year were retrospectively reviewed. All the reoperations were bilateral thyroidectomy and cervical lymph node excision.
Results:There were 76.8% patients with residual cancer in thyroid and cervical lymph node.There were 23 patients (16.7%) with recurrent laryngeal nerve injury that included 22 cases with unilateral and 1 case with bilateral injury after the initial operation, and 19 of the 23 patients with recurrent laryngeal nerve injury recovered after nerve repair.After thyroid reoperation, 3 cases(2.2%) had recurrent laryngeal nerve injury, 2 cases(1.4%) had partial parathyroid gland injury,2 cases(1.4%) had superior laryngeal nerve injury,but there were no cases of esophageal injury or postoperative bleeding.
Conclusions:The incidence of residual cancer is high after local excision for differentiated thyroid cancer, therefore, reoperation with bilateral thyroidectomy and cervical lymph node excision is necessary.