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ORIGINAL RESEARCH

Use of Intraoperative Gamma Probe in Selective Neck Dissection for Papillary Thyroid Cancer with Neck Metastasis Patients
Boyun Metastazlı Papiller Tiroid Kanseri Hastalarında Selektif Boyun Diseksiyonunda İntraoperatif Gama Prob Kullanımı
Received Date : 02 Aug 2024
Accepted Date : 30 Sep 2024
Available Online : 14 Oct 2024
Doi: 10.24179/kbbbbc.2024-105019 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2024;32(4):163-70.
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: The purpose of this study is to investigate the selective neck disection with use of intraoeprative gamma probe technique of which is performed due to determine dissection levels and extension, regards to reduce recurrence rates and complications. Material and Methods: The patients were divided two groups, of which first group designed as recurrent patients instead second group as non recurrent. The independent samples t-test was then used to compare the parameters with a normal distribution, according to the presence of a relapse, and the Mann-Whitney U test was used to compare the results with a non-normal distribution. Results: The study included 41 patients who underwent selective neck disection with use of gamma probe and total thyroidectomy with papillary thyroid cancer. In total, 12 (29.3%) patients’ disease recurred. The presence of recurrence did not depend on gender (p=0.398). While 12.5% of males (n=1) had recurrence, 33.3% of females (n=11) had recurrence. No statistically significant difference was obtained between the median values of the total number of malignant lymph nodes according to groups (p=0.174). There was no statistically significant difference between the median values of number of follow-up months according to patient group (p=0.148). Conclusion: The use of preoperative United States-mapping with intraoperative gamma probe in selective neck disection for patients with metastatic differentiated thyroid cancer is technically safe, and effective for determining the borders of the neck dissection of which is related with unnecessary surgical extension.
ÖZET
Amaç: Bu çalışmanın amacı, kansersiz sağkalımı sürdürmek ve komplikasyon oranını azaltmak amacıyla intraoperatif gamma prob tekniği kullanılarak yapılan selektif boyun diseksiyonunun etkinliğinin araştırılmasıdır. Gereç ve Yöntemler: Hastalar iki gruba ayrıldı; birinci grup nüks hastaları, ikinci grup ise nüks olmayan hastalar olarak tasarlandı. Daha sonra normal dağılıma sahip parametrelerin nüks varlığına göre karşılaştırılmasında bağımsız örneklem t-testi, sonuçların normal dağılıma uymayan durumlarla karşılaştırılmasında ise Mann- Whitney U testi kullanıldı. Bulgular: Çalışmaya papiller tiroid kanseri nedeniyle gama prob kullanılarak selektif boyun diseksiyonu ve total tiroidektomi uygulanan 41 hasta dâhil edildi. Toplamda 12 (%29,3) hastanın hastalığı tekrarladı. Nüks varlığı cinsiyete bağlı değildi (p=0,398). Erkeklerin %12,5’inde (n=1) nüks görülürken, kadınların %33,3’ünde (n=11) nüks görüldü. Toplam malign lenf nodu sayısının gruplara göre ortanca değerleri arasında istatistiksel olarak anlamlı bir fark elde edilmedi (p=0,174). Hasta grubuna göre takip ay sayısı ortanca değerleri arasında istatistiksel olarak anlamlı fark yoktu (p=0,148). Sonuç: Metastatik diferansiye tiroid kanserli hastalarda selektif boyun diseksiyonunda intraoperatif gama prob kullanımı, teknik olarak güvenli ve boyun diseksiyonu sınırlarını belirlemeye yardımcı bir metot olarak kullanılabilinir.
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