The first experience of laser spectroscopy in the surgical treatment of thyroid diseases

Abstract

For assessing the efficacy of intraoperative laser autofluorescent spectroscopy (IOLAS), 46 patients with thyroid diseases of different etiology are examined. The patients ’ aged varied from 30 to 65 years. The following morphological types of diseases were observed: benign nodular formations in 42 patients, thyroid cancer in 4, papillary TINO MO in 2, and follicular cancer TINO MO in 2 cases. Out of benign formations, 36 were multinodular colloid goiter and 6 follicle-cell adenomas. As a result of using IOLAS, thyroid cancer was diagnosed during surgery in 8 (17.4%) out of 36 patients with multinodular colloid goiter; this diagnosis necessitated more extensive intervention than was planned: subtotal resection had to be extended to thyroidectomy. In all the cases IOLAS data were confirmed by urgent and later planned histological analyses. Due to this method, no reoperations were needed, which previously had to be performed because of the data of planned histological analysis, and therefore, the probable complications of reoperations were prevented. Our data indicate that IOLAS more accurately identifies the type and morphology of thyroid involvement and helps choose adequate volume of intervention. The first experience with laser fluorescent study as optic biopsy holds good promise as regards improvement of intraoperative rapid diagnosis of thyroid diseases.