title: Intraoperative ultrasonography is useful in surgical management of neck metastases in differentiated thyroid cancers.
abstract: Differentiated thyroid carcinomas are the most common malignancies of endocrine organs. Metastases to cervical lymph nodes occur in 20-50% of cases. Recurrence and survival rates are closely related to the type of surgery performed. High-resolution ultrasonography (USG) is a sensitive imaging method used to detect occult lymph node metastases in patients with thyroid cancer. We evaluated how intraoperative USG affected surgical success. This was a retrospective study comparing two groups of patients with thyroid carcinoma who underwent cervical lymph node dissection. A total of 101 patients (33 males and 68 females) were included. Group 1 included 53 patients who underwent surgery with intraoperative USG guidance. Group 2 included 48 patients who underwent surgery without the use of USG. All patients were followed up (mean 23 months; range 5-44 months) with thyroglobulin measurements and USG evaluations. Group 1 (intraoperative USG) had a residual/recurrent tumor rate of 1.9% (1/53 patients). Group 2 had a residual/recurrent tumor rate of 12.5% (6/48 patients). A statistically significant difference appeared between the residual/recurrent tumor rates in Groups 1 and 2 (p<0.05). In addition to its classical use in diagnosis and follow-up, intraoperative use of high-resolution USG can improve surgical success and may decrease the number of residual/recurrent tumors encountered during follow-up.
authors.affiliation: Department of Otorhinolaryngology, Acibadem Maslak Hospital, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Ertas
authors.forename: Hakan
authors.initials: H
authors.lastname: Kaya
authors.forename: Neslihan
authors.initials: N
authors.lastname: Kurtulmus
authors.forename: Abdullah
authors.initials: A
authors.lastname: Yakupoglu
authors.forename: Serdar
authors.initials: S
authors.lastname: Giray
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Unal
authors.forename: Mete
authors.initials: M
authors.lastname: Duren
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology*; D013965:Thyroidectomy; D014463:Ultrasonography; D055815:Young Adult