Does intraoperative radioguided surgery influence the complication rates and completeness of completion thyroidectomy?

Abstract 

Background

To investigate whether radioguided surgery (RGS) has any beneficial effects on the complication rates and the completeness of completion thyroidectomy (CT) in a center experienced in endocrine surgery.

Methods

Thirty-three patients scheduled for CT for thyroid carcinoma were randomly selected for 2 types of intervention. CT was performed by RGS following administration of 5 mCi technetium-99m in 15 patients (group 1) and with conventional surgical exploration without RGS in 18 patients (group 2). The duration of the CT, thyroid function tests, iodine-131 uptake at 24 hours at the third postoperative week, and complication rates were compared between groups 1 and 2.

Results

In groups 1 and 2, the duration of CT (63.3 ± 7.5 vs 65 ± 10.8 minutes, P = .7), postoperative serum thyrotropin-stimulating hormone (TSH) levels (43.9 ± 17.5 mIU/L vs 36.8 ± 8.6 mIU/L, P = .2), postoperative ¹³¹I uptake at 24 hours (6.86 ± 1.7 vs 7.0 ± 1.3, P = .8), and complication rates (13.3% vs 5.6%, P = .6) showed no significant differences.

Conclusion

RGS during CT offers no benefit over conventional surgical exploration with respect to operation time, complication rates, or completeness of surgery in a center experienced in endocrine surgery. However, it might be helpful for general surgeons who are less familiar with re-operative thyroid surgery.

Keywords: Completeness and complication rates, Completion thyroidectomy, Radioguided surgery, Experience