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
Mehmet Burak AŞIKa, Ramazan YILDIZb
aAnkara Memorial Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Ankara, Türkiye
bAnkara Memorial Hospital, Department of Endocrine and General Surgery, Ankara, Türkiye
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.
Keywords: Thyroid; papillary thyroid cancer; neck metastasis; neck dissection
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.
Anahtar Kelimeler: Tiroid; papiller tiroid kanseri; boyun metastazı; boyun diseksiyonu
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