title: Completion thyroidectomy of well-differentiated thyroid cancer - a prospective, randomised study.
abstract: BACKGROUND
  Postoperatively diagnosed papillary or follicular thyroid cancer in subtotally thyroidectomised patients requires a completion thyroidectomy. Re-operation with a gamma probe can be particularly useful in these patients. The aim of this study was to evaluate the benefits of using an intraoperative hand-held gamma detector during completion thyroidectomy in patients with well-differentiated thyroid cancer (WTC).
  
  
  METHODS
  75 patients with WTC qualified for total re-thyroidectomy. In 43 patients, Group I (Nav), a hand-held gamma probe (Navigator GPS) was used intraoperatively. 32 patients were re-operated without the gamma probe (Group II). In Group I, thyroid remnants were removed based on counted gamma signals. To estimate the radicality of reoperation in both groups, thyroglobulin (Tg) levels were determined and total body scanning (TBS) - I(131) uptake - was performed.
  
  
  RESULTS
  Total thyroidectomy with central lymphadenectomy was performed in 75 cases. The average level of Tg and iodine uptake after radicalisation was lower in Group I (Nav) than in Group II (3.32 ± 2.09 v. 4.58 ± 2.5 ng/mL, respectively, for Tg [p = 0.021] and 6.29 ± 3.38 v. 7.31 ± 2.29 ng/mL, respectively, for iodine uptake [p = 0.187]). Additionally, the frequency of postoperative complications was comparable, the difference in both groups was not significant, despite the use of the gamma probe (p = 0.109).
  
  
  CONCLUSIONS
  The intraoperative use of a hand-held gamma detector can help to improve the radicality of a completion thyroidectomy procedure after an incomplete primary thyroid resection, but the results of this procedure in the hands of an experienced surgeon are comparable whether or not the gamma detector is used.
authors.affiliation: mproczko@gumed.edu.pl.
authors.forename: Monika
authors.initials: M
authors.lastname: Proczko
authors.forename: Tomasz
authors.initials: T
authors.lastname: Stefaniak
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Sworczak
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kobiela
authors.forename: Andrzej Jacek
authors.initials: AJ
authors.lastname: Lachiński
authors.forename: Pieter
authors.initials: P
authors.lastname: Stepaniak
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Sledziński
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007455:Iodine / Q000493:pharmacokinetics; D007457:Iodine Radioisotopes; D008197:Lymph Node Excision; D016343:Monitoring, Intraoperative / Q000379:methods; D009367:Neoplasm Staging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012086:Reoperation; D013954:Thyroglobulin / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods
chemical_list: D007457:Iodine Radioisotopes; D013954:Thyroglobulin; D007455:Iodine