title: Role of intraoperative frozen section in the management of thyroid nodules.
abstract: BACKGROUND
  The role of intraoperative frozen section in the management of thyroid nodules is controversial. Its potential benefit is to facilitate one-stage total thyroidectomy. Most literature on this topic originates from overseas tertiary referral centres with a high percentage of cancer cases and a fully resourced frozen section service. The aim of the present study was to review all patients undergoing frozen section at a typical general surgical department in New Zealand (North Shore Hospital, Auckland) to see how often frozen section altered surgical strategy.
  
  
  METHODS
  A retrospective review of all frozen sections between November 1999 and June 2003 was performed. Patient records, operation notes and pathology reports were reviewed.
  
  
  RESULTS
  Forty-seven sequential frozen sections were included in the study. Thirteen patients had thyroid carcinoma (five follicular, three Hurthle cell, and five papillary). In only one patient did the result of an intraoperative frozen section result in a total thyroidectomy being performed instead of a thyroid lobectomy. The reason for this was the rare condition of Riedel's thyroiditis. In no patients did frozen section detect a cancer that was not diagnosed on preoperative fine-needle aspirate biopsy.
  
  
  CONCLUSIONS
  The present review found little benefit in performing intraoperative frozen section in this setting. As a diagnostic test the cost of frozen section (NZ $200 for each frozen section) needs to be weighed against its low clinical benefit.
authors.affiliation: Department of General Surgery, Waitemata Health, North Shore Hospital, Auckland, New Zealand.
authors.forename: Zarina
authors.initials: Z
authors.lastname: Wong
authors.forename: Carl
authors.initials: C
authors.lastname: Muthu
authors.forename: Jan
authors.initials: J
authors.lastname: Craik
authors.forename: Jim
authors.initials: J
authors.lastname: Carter
authors.forename: C Richard
authors.initials: CR
authors.lastname: Harman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D005629:Frozen Sections; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000473:pathology*; D016606:Thyroid Nodule / Q000473:pathology* / Q000601:surgery*; D013965:Thyroidectomy