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Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
FRANCO-CASTANEDA, Ximena and CHALA-GALINDO, Andrés Ignacio. Intraoperative localization of recurrences in thyroid cancer by ultrasound-guided injection of methylene blue. rev. colomb. cir. [online]. 2021, vol.36, n.4, pp.611-619. Epub Feb 15, 2022. ISSN 2011-7582. https://doi.org/10.30944/20117582.856.
Introduction.
The approach of a previously operated neck for metastasis resection faces a challenge to achieve a successful resection. The present study aims to demonstrate the usefulness of the ultrasound-guided injection of methylene blue technique for the intraoperative localization of recurrent lesions in thyroid cancer to facilitate their resection.
Methods.
An observational, descriptive and retrospective study was conducted in patients reoperated for recurrences of differentiated thyroid carcinoma over a period of two and a half years, using ultrasound-guided intratumoral injection of methylene blue for its intraoperative identification. An analysis of demographic and clinical variables was carried out and its advantages over other methods were identified.
Results.
This study included 10 procedures in nine patients, 77.8% women and 22.2% men, with a mean age of 54 years. All had a detectable and elevated thyroglobulin level before the intervention, 89% had a decrease in its level and 33% had an adequate biochemical response. The technique added 10 minutes to the surgical time. All marked lymph nodes were identified intraoperatively. The average number of lymph nodes resected was 12, of which six were positive, all with papillary thyroid carcinoma. It was considered of great utility and low cost in all cases.
Discussion.
This technique shows to be an effective strategy for the intraoperative identification of locoregional recurrences in thyroid carcinoma, allowing a successful lymph node dissection, reducing complications, surgical time and especially costs compared to other interventions.
Keywords : papillary thyroid cancer; local recurrence of neoplasia; lymph node excision; reoperation; methylene blue; ultrasonography.