[Significance of intraoperative isotope detection in primary and secondary radical surgical treatment of thyroid cancer].

When diagnosis of the thyroid carcinoma is made preoperatively, total thyroidectomy with excision of lymph nodes involved in neoplastic process is indicated. The cases of carcinoma diagnosed upon tissue examination after strumectomy performed for other indications should be referred for radical rethyroidectomy. Even after macroscopically total thyroidectomy, postoperative scintigraphy may reveal remnants of thyroid tissue, the most often in the place of pyramidal lobe, in proximity of the laryngeal recurrent nerves or small metastatic lymph nodes overlooked during the first operation. In order to improve the rate of surgical cure, intraoperative scintigraphy was performed. Intraoperative evaluation of totality of the operation was performed in 114 patients. In all cases postoperative scintigraphy revealed iodine uptake above 1% (ranging from 1.9% to 23%). The other group of 186 patients had the radicalness of total thyroidectomy and total rethyroidectomy checked intraoperatively with gamma-beams detector. Radioiodine uptake ranged postoperatively in these patients from 0% to 3.74%. Only 73 (39%) of them required radioiodine treatment due to iodine uptake above the neck. The intraoperative use of gamma-beams detector allows improving totality of thyroidectomy and for significant reduction in number of patients who require ablation with radioiodine.