Dongbin Ahn1, Jin Ho Sohn, Heejin Kim. 1. Department of Otolaryngology-Head and Neck Surgery, Kyungpook National University, 807 Hogukno, Buk-gu, Taegu, 702-210, Republic of Korea, godlikeu@naver.com.
Abstract
BACKGROUND: Identification and removal of small, non-palpable tumors located within previous surgical scar tissue is challenging and time consuming and may be associated with increased risk in patients with recurrent papillary thyroid carcinoma (PTC). The purpose of the present study was to present our surgeon-performed technique and to evaluate the usefulness of ultrasound-guided intratumoral indigo carmine injection (US-III) for intraoperative tumor localization in patients with recurrent PTC. METHODS: Sixteen patients with recurrent PTC in which tumors were <1.5 cm and not palpable were enrolled in this prospective study from January 2012 through March 2013. RESULTS: The mean size of the target tumors was 0.85 cm (range 0.4-1.3 cm) on preoperative US. The average time required for the US-III procedure was 7.7 min (range 5-11 min). The mean volume of injected indigo carmine was 0.56 mL (range 0.3-1.0 mL); this injection expanded the tumors by a mean of 0.2 cm (23.5% increase compared with the initial tumor size; range 0.0-0.4 cm), increasing the mean size of the target tumors to 1.05 cm (range 0.5-1.5 cm). In 15 (93.8%) of the 16 patients, the recurrent tumors were successfully removed with the aid of US-III. No complications occurred in any of the patients as a result of the US-III or subsequent surgeries. CONCLUSIONS: US-III is a safe and effective technique that can be performed by the surgeon for the intraoperative localization of small non-palpable tumors within previous scar tissue in patients with recurrent PTC.
BACKGROUND: Identification and removal of small, non-palpable tumors located within previous surgical scar tissue is challenging and time consuming and may be associated with increased risk in patients with recurrent papillary thyroid carcinoma (PTC). The purpose of the present study was to present our surgeon-performed technique and to evaluate the usefulness of ultrasound-guided intratumoral indigo carmine injection (US-III) for intraoperative tumor localization in patients with recurrent PTC. METHODS: Sixteen patients with recurrent PTC in which tumors were <1.5 cm and not palpable were enrolled in this prospective study from January 2012 through March 2013. RESULTS: The mean size of the target tumors was 0.85 cm (range 0.4-1.3 cm) on preoperative US. The average time required for the US-III procedure was 7.7 min (range 5-11 min). The mean volume of injected indigo carmine was 0.56 mL (range 0.3-1.0 mL); this injection expanded the tumors by a mean of 0.2 cm (23.5% increase compared with the initial tumor size; range 0.0-0.4 cm), increasing the mean size of the target tumors to 1.05 cm (range 0.5-1.5 cm). In 15 (93.8%) of the 16 patients, the recurrent tumors were successfully removed with the aid of US-III. No complications occurred in any of the patients as a result of the US-III or subsequent surgeries. CONCLUSIONS: US-III is a safe and effective technique that can be performed by the surgeon for the intraoperative localization of small non-palpable tumors within previous scar tissue in patients with recurrent PTC.
Authors: David S Cooper; Gerard M Doherty; Bryan R Haugen; Bryan R Hauger; Richard T Kloos; Stephanie L Lee; Susan J Mandel; Ernest L Mazzaferri; Bryan McIver; Furio Pacini; Martin Schlumberger; Steven I Sherman; David L Steward; R Michael Tuttle Journal: Thyroid Date: 2009-11 Impact factor: 6.568
Authors: Dana M Hartl; Linda Chami; Abir Al Ghuzlan; Sophie Leboulleux; Eric Baudin; Martin Schlumberger; Jean-Paul Travagli Journal: Ann Surg Oncol Date: 2009-06-24 Impact factor: 5.344