BACKGROUND: Frozen section (FS) evaluation during thyroid surgery is often used to guide intraoperative management. We sought to determine the utility of FS in patients undergoing thyroidectomy for multinodular thyroid disease. METHODS: From May 1994 through November 2004, 236 patients with multinodular goiter underwent thyroidectomy at our institution. Patient data were retrospectively analyzed to see if a frozen section was performed during the procedure and whether it changed the patient's outcome. RESULTS: Of the 236 patients, 135 (57%) had intra-operative FS. There were no differences between patients who had FS analysis and those who did not with regard to age, gender, and the incidence of malignancy. Of the patients who had FS, 4/135 (3%) were subsequently diagnosed with thyroid cancer on permanent histology. Three of these FS were misread as benign. Therefore, the sensitivity of FS for the diagnosis of thyroid cancer was only 25%. Importantly, in none of the 135 patients did FS alter the intraoperative management. CONCLUSION: While FS was commonly used in patients undergoing thyroidectomy at our institution, in no patient over the last decade did FS correctly alter the intraoperative management. Given the time required to perform FS and the cost associated with it, we believe that routine FS should not be performed in these patients.
BACKGROUND: Frozen section (FS) evaluation during thyroid surgery is often used to guide intraoperative management. We sought to determine the utility of FS in patients undergoing thyroidectomy for multinodular thyroid disease. METHODS: From May 1994 through November 2004, 236 patients with multinodular goiter underwent thyroidectomy at our institution. Patient data were retrospectively analyzed to see if a frozen section was performed during the procedure and whether it changed the patient's outcome. RESULTS: Of the 236 patients, 135 (57%) had intra-operative FS. There were no differences between patients who had FS analysis and those who did not with regard to age, gender, and the incidence of malignancy. Of the patients who had FS, 4/135 (3%) were subsequently diagnosed with thyroid cancer on permanent histology. Three of these FS were misread as benign. Therefore, the sensitivity of FS for the diagnosis of thyroid cancer was only 25%. Importantly, in none of the 135 patients did FS alter the intraoperative management. CONCLUSION: While FS was commonly used in patients undergoing thyroidectomy at our institution, in no patient over the last decade did FS correctly alter the intraoperative management. Given the time required to perform FS and the cost associated with it, we believe that routine FS should not be performed in these patients.
Authors: Hee Jung Moon; Jin Young Kwak; Eun-Kyung Kim; Min Jung Kim; Cheong Soo Park; Woung Youn Chung; Eun Ju Son Journal: World J Surg Date: 2009-05 Impact factor: 3.352
Authors: David Yü Greenblatt; Rebecca Sippel; Glen Leverson; James Frydman; Sarah Schaefer; Herbert Chen Journal: World J Surg Date: 2009-02 Impact factor: 3.352
Authors: João Paulo Alves de Almeida; Sergio Dias do Couto Netto; Rafael Pinto da Rocha; Elio G Pfuetzenreiter; Rogério Aparecido Dedivitis Journal: Braz J Otorhinolaryngol Date: 2009 Mar-Apr