Surgical Treatment Of Thyroid Cancer Research Articles

Intraoperative indocyanine green angiography in preventing hypoparathyroidism after thyroid cancer surgery.

The aim of this study was to determine whether the use of indocyanine green angiography to identify devascularized parathyroids during thyroidectomy for thyroid cancer would decrease the rates of postoperative hypoparathyroidism. Retrospective study of patients who had undergone total thyroidectomy for treatment of thyroid cancer between March 2021 and March 2023. The indocyanine group included patients with all four parathyroids identified and evaluated by indocyanine green angiography at the end of the procedure. Those with parathyroid glands classified with no vascularization had the glands autotransplanted. A group without indocyanine angiography was used to compare results. The analysis included 100 patients in each group. Indocyanine angiography identified 14.75% of devascularized parathyroids at surgery. The number of parathyroids with a score of 2 (i.e., good vascularization) was not a safe predictor of normal parathyroid hormonelevels after surgery. Indeed, 29.2% of the patients with three parathyroids with a score of 2 developed transient hypoparathyroidism. Permanent hypoparathyroidism occurred in 7% of the patients without indocyanine group and in none of the patients in the indocyanine group (p = 0.014). Intraoperative angiography with indocyanine green could contribute to reduce the occurrence of permanent hypoparathyroidism in patients undergoing surgical treatment for thyroid cancer.

Investigating potential disparities by exploring time to surgical thyroid cancer treatment

(1) Delays in initial treatment have been a frequently used metric for assessing disparities in medicine; however, there has been sparse literature on treatment delays in thyroid cancer. We therefore aimed to assess disparities by investigating the association between race/ethnicity, insurance type, and socioeconomic status and time to surgical treatment of thyroid cancer. (2) A retrospective chart review was conducted to collect demographic and clinical data from 443 surgical thyroid cancer patients at Mount Sinai Hospital in 2018–2019. We investigated the time between thyroid cancer diagnosis and surgery by race/ethnicity, insurance, and income groups. (3) Univariate analysis showed that race/ethnicity, insurance type, and SES alone were not statistically significant predictors of earlier time to treatment (p = 0.766, 0.339, 0.435, respectively). On multivariable linear regression, time between diagnosis and surgical treatment was not significantly different for racial minorities compared to non-Hispanic White patients, patients with Medicare/Medicaid compared to private insurance, and patients with lowest income quartile (<$54,585) compared to those with the highest (≥$116,560). (4) Present study showed no significant delays in treatment for different racial/ethnic, insurance, and income groups.

Anxiety and Depression as Potential Predictors for Shorter Time to Undergo Initial Surgical Treatment for Papillary Thyroid Cancer

(1) Background: A pre-existing psychiatric condition may impact decision making by patients and/or physicians following a thyroid cancer diagnosis, such as potentially electing surgery over active surveillance, thus shortening the time to cancer removal. This is the first study to investigate the association between pre-existing anxiety and/or depression and time to receive surgical treatment for thyroid cancer. (2) Methods: Retrospective data were collected from 652 surgical thyroid cancer patients at our institution from 2018 to 2020. We investigated the time between thyroid cancer diagnosis and surgery, comparing patients with pre-existing anxiety and/or depression to those without. (3) Results: Patients with anxiety, depression, and both anxiety and depression had a significantly shorter time between diagnosis and surgery (51.6, 57, and 57.4 days, respectively) compared to patients without (111.9 days) (p = 0.002, p = 0.004, p = 0.003, respectively). (4) Conclusions: Although little is known about the impact of pre-existing psychiatric conditions in the decision-making process for thyroid cancer surgery, this present study showed that anxiety and/or depression may lead to more immediate surgical interventions. Thus, psychiatric history may be an important factor for physicians to consider when counseling patients with thyroid cancer.

The TOFr of 0.75 to 0.85 is the optimal timing for IONM during thyroid surgery: a prospective observational cohort study

BackgroudRecurrent laryngeal nerve (RLN) injury is one of the serious complications of thyroid tumour surgery, surgical treatment of thyroid cancer requires careful consideration of the RLN and its impact on glottis function. There has been no unified standard for precise neuromuscular block monitoring to guide the monitoring of RLN in thyroid surgery. This study aimed to investigate the correlation between Train-of-four stabilization ratio (TOFr) and neural signal values of intraoperative neurophysiological monitoring (INOM) during thyroid operation, and further to determine the optimal timing for INOM during thyroid operation.MethodsPatients scheduled for thyroid tumour resection with INOM and RLN monitoring from April 2018 to July 2018 in our center were recruited. Electromyography (EMG) signals and corresponding TOFr were collected. All nerve stimulation data were included in group VR. Vagus nerve stimulation data were included in Subgroup V. RLN stimulation data were included in Subgroup R. The timing of recording was as follows: Vagus nerve EMG amplitude after opening the lateral space between the thyroid and carotid sheath and before the initiation of thyroid dissection, RLN EMG amplitude at first recognition, RLN EMG amplitude after complete thyroid dissection (Repeat three times), and Vagus nerve EMG amplitude after resection of the thyroid (Repeat three times). Correlation analysis of continuous variables was described by a scatter diagram. Pearson correlation analysis or Spearman correlation analysis was used for the two groups of variables.ResultsFinally, 134 vagus nerve signals and 143 RLN signals were analysed after matching with TOFr. The EMG amplitude in the VR group and subgroups after nerve stimulation was positively correlated with TOFr (p < 0.05). In the VR, V and R group, the incidence of EMG ≥ 500 µV in the 0.75 < TOFr ≤ 0.85 interval was significantly higher than the 0 < TOFr ≤ 0.75 interval (P = 0.002, P = 0.013 and P = 0.029), and has no statistical difference compared to 0.85 < TOFr ≤ 0.95 interval (P > 0.05).ConclusionsThe EMG signals of the RLN and vagus nerve stimulation during thyroid surgery were positively correlated with TOFr. TOFr > 0.75 could reflect more than 50% of the effective nerve electrophysiological signals, 0.75 < TOFr ≤ 0.85 interval was the optimal timing for IONM during thyroid surgery.Trial registrationChinese Clinical Trial Registry (ChiCTR1800015797) Registered on 20/04/2018. https://www.chictr.org.cn.

Medical Spanish Endocrinology Educational Module.

IntroductionHispanic/Latinx patients experience health disparities in endocrine disease, such as higher rates of mortality due to diabetes mellitus, worse outcomes in the surgical treatment of thyroid cancer, and lack of knowledge about bone health and osteoporotic fracture prevention. Educational strategies to teach cultural and linguistic medical Spanish knowledge to medical students have the potential to improve Hispanic/Latinx endocrine health.MethodsWe created an 8-hour medical Spanish endocrine module targeting language and cultural skills acquisition. Specifically, students practiced obtaining a past medical history, obtaining a medications history, providing and explaining a diagnosis, explaining discharge instructions, and discussing sociocultural aspects of endocrine health. We divided the module into four 2-hour sessions: (1) preclass self-study, (2) class period, (3) role-play/interviewing practice session, and (4) case/cultural activity assignment. Participants completed a pre- and postassessment to measure student confidence level and knowledge.ResultsWe implemented the module four times at one medical school, with 47 fourth-year medical students with intermediate or higher general Spanish skills. Confidence increased for all learners in the endocrine-focused interview and exam in Spanish. Heritage Spanish learners, who were exposed to Spanish at home as children, reported higher postmodule confidence in eliciting the past medical history of endocrine problems.DiscussionThe medical Spanish endocrine module improved the communication skills of medical students with intermediate through advanced Spanish proficiency. Future study should evaluate learner clinical performance metrics and applications to other groups of learners, such as resident physicians or health professions involved in the care of patients with endocrine disease.

Transoral Endoscopic Thyroidectomy by Vestibular Approach for Differentiated Thyroid Cancer Intraoperatively Invading Strap Muscle.

Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has become increasingly popular in the surgical treatment of thyroid cancer. However, its application in T3b disease has not been well-defined. We conducted a quasi-experimental study on patients with an intraoperative diagnosis of T3bN0M0 differentiated thyroid carcinoma from January 2019 to January 2021 in our institution. Surgical and early oncological outcomes were assessed. Among 326 patients who underwent TOETVA for thyroid cancer, 12 cases had T3bN0M0 disease intraoperatively. The mean operation time was 136.67±7.32 minutes, with 7.17±0.83 mL of blood loss. No patients reported symptoms of postoperatively transient hypoparathyroidism, mental nerve, or recurrent laryngeal nerve injury. After radioactive iodine therapy, all patients had undetectable thyroglobulin, negative antithyroglobulin, and normal neck ultrasound. TOETVA seems to be a surgically and oncological safe method for differentiated thyroid cancer patients with small tumors invading strap muscle intraoperatively. The patients can be well-managed with endoscopic total thyroidectomy and postoperative radioactive iodine therapy. Further studies with a larger sample size and longer follow-up are needed to provide more solid evidence.

Application of Nano-Carbon Tracing Technology in Thyroid Cancer and Its Relationship with Cytotoxic T Lymphocyte Antigen 4 Gene Polymorphism.

The most common malignant tumor of the human endocrine system is thyroid cancer, most used surgical treatment for thyroid cancer is total thyroidectomy with central lymph node dissection. However, surgery and thorough lymph node dissection can easily damage the parathyroid glands and cause corresponding surgery. Symptoms such as permanent hyperparathyroidism, nano-carbon is a common type of new lymphoid tissue tracer, it is mainly used to trace lymphoid tissue in tumor surgery. With the continuous advancement of surgical technology, more and more scholars have used nano-carbon to trace lymphoid tissue during thyroid cancer surgery, and have achieved good results. The results of this study show that thyroid cancer surgery with nano-carbon to negatively develop the parathyroid glands significantly reduces the incidence of serum PTH and blood calcium decline, and largely protects the parathyroid glands. Practice has also shown that the use of nano-carbon tracers is more thorough in lymph node dissection than thyroid cancer surgery without nano-carbon tracers.

Hemithyroidectomy for Thyroid Cancer: A Review.

Thyroid cancer incidence is on the rise; however, fortunately, the death rate is stable. Most persons with well-differentiated thyroid cancer have a low risk of recurrence at the time of diagnosis and can expect a normal life expectancy. Over the last two decades, guidelines have recommended less aggressive therapy for low-risk cancer and a more personalized approach to treatment of thyroid cancer overall. The American Thyroid Association (ATA) and National Comprehensive Cancer Network (NCCN) thyroid cancer guidelines recommend hemithyroidectomy as an acceptable surgical treatment option for low-risk thyroid cancer. Given this change in treatment paradigms, an increasing number of people are undergoing hemithyroidectomy rather than total or near-total thyroidectomy as their primary surgical treatment of thyroid cancer. The postoperative follow-up of hemithyroidectomy patients differs from those who have undergone total or near-total thyroidectomy, and the long-term monitoring with imaging and biomarkers can also be different. This article reviews indications for hemithyroidectomy, as well as postoperative considerations and management recommendations for those who have undergone hemithyroidectomy.

Radioactive iodine treatment of papillary thyroid carcinoma in Japan.

We have a unique history of using radioactive iodine (RAI) therapy and surgical treatment for thyroid cancer in Japan. Less than total thyroidectomy without RAI therapy was the most common management of papillary thyroid carcinoma (PTC) in the past. Limited availability of dedicated facilities for the RAI administration due to the strict regulations and insufficient coverage of the expenses were the major reasons that impacted on the management decisions. Following the publication of the Japanese clinical practice guidelines for thyroid tumors in 2010, the risk-adapted approach has become a standard where the high-risk and selected intermediate-risk PTC patients undergo total thyroidectomy followed by RAI therapy and thyrotropin suppression therapy. We are on the shoulders of pioneers who made every effort to bring the interventions closer to an ideal environment for patients. Armed with the revised clinical practice guidelines 2018 and devised inpatient/outpatient RAI therapy, Japanese physicians are ready to proceed to more rational management that would improve patients' outcomes. Directions for the future include further advancement of relevant clinical research to fill the gaps between current evidence and recommendations in the guidelines, and obtaining approval for high-dose RAI therapy on an outpatient basis to improve its effectiveness in both adjuvant and treatment settings.

No Significant Difference in Outcomes for Surgical Treatment of Thyroid Cancer in Kidney Transplant Recipients - Analysis of the HCUP NIS Data

Solid organ transplant recipients, and in particular Kidney Transplant (KTx) patients, are at increased risk for developing thyroid cancers due to immunosuppression and improved long-term survival post-transplant. Using the HCUP NIS database, we compared mortality rate, disposition, LOS, and total hospital charge between KTx and Non-KTx patients following thyroidectomy for thyroid cancer during 2008-2014.

Explaining the Variation in Surgical Practice for Differentiated Thyroid Cancer in Ontario, Canada

In the management of differentiated thyroid cancer (DTC), the extent of surgical treatment required for most patients remains controversial and varies widely. This variation may be associated with the Enthusiasm Hypothesis, the notion that geographic differences in use of health care services are driven by the prevalence of physicians with a preference for particular services. To evaluate the Enthusiasm Hypothesis and its applicability to the variation in the surgical treatment of thyroid cancer in Ontario, Canada. This population-based study obtained electronic data on all health care-associated events for the complete population of insured residents of Ontario, Canada. Patients (n = 28 754) who were 18 years of age or older and underwent an initial therapeutic thyroid surgical procedure for a papillary or follicular carcinoma diagnosis between January 1, 2000, and December 31, 2015, were included. The final data analysis was performed January 31, 2019. Therapeutic thyroid cancer surgical procedure. Numbers of surgeons, extent of surgical treatment, and case volumes in 14 geographic regions in Ontario. In total, 28 754 patients with DTC were included, of whom 22 600 (78.6%) were female, with a mean (SD) age of 49 (14) years. The use of total thyroidectomy for DTC varied widely across geographic regions of Ontario, from 45.8% to 77.1% of all cancer cases. More than 90% of the overall variation in practice (total thyroidectomy vs less-than-total thyroidectomy) could be explained by the practices of the high-volume surgeons (enthusiasts) in regions with the highest rates of thyroid cancer diagnosis. The Enthusiasm Hypothesis appears to be consistent with the findings of this study. The practices of the high-volume surgeons who were enthusiastic for total thyroidectomy in the geographic regions with the highest rates of thyroid cancer diagnosis may account for the variation in practice across Ontario between 2000 and 2015.

Method of preoperative labeling of lymph nodes affected by thyroid cancer metastases to facilitate their intraoperative identification

Objective. In surgical treatment of thyroid cancer, the appropriate resection of lymph nodes affected by metastases is mandatory. Minimally invasive inter­vention for metastatic process in thyroid cancer is alternative method of treatment in case of solitary neck metastases. The specific complications associa­ted with surgical trauma occur in cases of repeated interventions, namely the damage of Х, ХІ, and ХІІ pairs of cranial nerves, motor and sensory fibers of the cervical and brachial plexus, lymphorrhea. Complications associated with dissection of lymph drainage collectors lead to prolongation of post­operative stay in hospital. Thus, the need to minimize surgery risk and to increase efficacy of lymp­ha­den­e­ctomies in primary and repea­ted neck dissections emerges. The aim is to develop method of preoperative la­­beling of lymph nodes affected by thyroid cancer metastases to facilitate their intraoperative identi­fication. Materials and methods. The methylene blue dye for biological tissue labeling was used. In preoperative period, 24 hours before surgery FNAP was performed under the ultrasonography control with the purpose of metastatic lesion verification and then the 1 % solution of methylene blue dye was injected directly to affected node. During the dissection the labeled node was identified by its blue color. Results and discussion. Lymph nodes of different collector groups were labeled in 10 patients. The visual intraoperative identification of lymph node was feasible in all patients. The operation time was shortened in 9 patients (90 %). The mean decrease of operation time was 31.2 ± 7.6 min (p ≤ 0.05). The consecutive patho­logical investigation of all removed labelled lymph nodes confirmed the presence of metastatic thyroid cancer. Conclusion. The preoperative labeling of affected lymph nodes 24 hours ahead surgery is efficient, easy to use and cost-saving method of visualization which allows to mitigate excessive surgical traumatization during the lymph neck dissection and to decrease the operation time.

Complication versus Radicality in Papillary Thyroid Cancer Surgery: How to Keep the Balance?

Background: Controversy exists over the extent of surgical treatment of papillary thyroid cancer.Reoperations may carry a significant risk of surgical complications. The aim of this study is to investigate the complications following surgical treatment of thyroid cancer and the association between the extent of surgery and complication rates. Methods: A total of 196 patients with papillary thyroid cancer were retrospectively reviewed to identify extent of surgery and associated complications, between 2009 and 2018 atSouth Egypt Cancer Institute Assiut University. Results: Primary procedures included less-than-total thyroidectomy (near total thyroidectomy in 5.1%, subtotal thyroidectomy in 4.1%, thyroid lobectomy in 3.1%) and total thyroidectomy in 87.8% (18.9% of them are completion thyroidectomy). No lymph nodes dissection was done in 10.7%, Berry picking in 6.1%, central compartment neck dissection in 41.8%, central compartment neck dissection with modified ipsilateral radical neck dissection in 12.2%, central compartment neck dissection with modified bilateral radical neck dissection in 26.0%, central compartment dissection with both modified bilateral radical neck dissection and superior mediastinal lymph node dissection 3.1%. The most common surgical complication were transient hypoparathyroidism (16.7% - 45.8%) and 2.0% permanent, transient vocal cord palsy (7.3% - 16.7%), and 3.9% permanent, hematoma 1.5%, seroma 7.1% and chyle fistula in 2.6% of patients. Conclusion: Thyroid cancer surgeries are safe. The transient complication rates of hypoparathyroidism increased significantly with increasing the extent of surgery.

BABA of da Vinci robot thyroid surgery in the standard treatment of thyroid cancer surgery

Thyroid cancer is the most common malignant tumor in endocrine surgery. Surgery is the first choice for most patients with thyroid cancer. Da Vinci robot system as the auxiliary system is the most advanced endoscopic surgery, largely to fill the cavity mirror device cannot bend, complex operation and so on insufficiency, has now become an important way of surgical treatment of thyroid cancer, and its curative effect, high safety, but because of the economic cost is higher, is currently not widespread popularity.

Metastasis and dissection of lymph node posterior to right recurrent laryngeal nerve of papillary thyroid carcinoma

Lymph node metastasis is the main mode of metastasis of thyroid papillary carcinoma. In the central compartment lymph node dissection, the lymph node posterior to right recurrent laryngeal nerve is hidden because of its deep anatomical position, which is easy to be missed during the operation and becomes one of the factors that affect the recurrence of thyroid papillary carcinoma. The metastasis rate of lymph node posterior to right recurrent laryngeal nerve is 10%-30%, which is related to the tumor size, location and other factors, and its position in the surgical treatment of thyroid cancer is increasingly prominent. Key words: Thyroid neoplasms; Lymphatic metastasis; Neck dissection; Lymph node posterior to right recurrent laryngeal nerve

Endocrine Complications of Surgical Treatment of Thyroid Cancer: An Update.

Postoperative hypoparathyroidism (HypoPT) and hypothyroidism (HypoT) are the main endocrine complications after the surgical treatment for thyroid cancer. Postsurgical HypoPT can be transient, protracted or permanent. Its frequency varies according to the underlying cervical pathology, surgical technique, and mainly the experience of the surgeon. Risk factors for HypoPT include aggressiveness of the tumor, extent of surgery, the presence of parathyroid gland in the pathologic specimen, and surgeon experience. Clinical manifestations of postsurgical HypoPT can be acute or chronic. An adequate surgical technique that minimizes trauma and preserve the vascularization of the parathyroid glands is the better procedure to reduce the risk of postoperative HypoPT. Acute hypocalcemia may be managed with intravenous or oral calcium supplements, according to the level of serum calcium and the presence of signs and symptoms. Patients with permanent HypoPT require lifelong calcium and vitamin D supplementation. Calcitriol is the vitamin D metabolite of preference because of its high activity and short half-life. Both PTH (1-34) and intact PTH (1-84) have demonstrated to be attractive options in hypoparathyroid patients who cannot maintain stable serum and urinary calcium levels with calcium and vitamin D supplementation. However, the long-term safety of these preparations has not been established. Postsurgical HypoT is an unavoidable consequence of total or near-total thyroidectomy for thyroid cancer. Replacement and suppressive therapy are necessary in these patients. Thyroid hormone suppression therapy has shown to be accompanied by a decreased risk of disease progression and recurrence; however, it may also be associated with increased risk of dysrhythmia and loss of bone mass. Therefore, the intensity of TSH suppression must be established in a personalized way after balancing risk and benefits, according to the severity of the thyroid cancer, the response to therapy, and the individual risk factors for adverse events.

Comparative evaluation of preand postoperative predictors of hypocalcemia in patients with thyroid cancer

The objectives of this study was to identify the incidence of hypocalcemia, depending on the surgery and to examine the main predictors of postoperative hypocalcemia in patients with adenocarcinoma of the thyroid for medical treatment.Materials and Methods. Data were collected prospectively from 2011 to 2014. We analyzed 98 patients after surgical treatment for thyroid cancer. All patients underwent thyroidectomy, some patients without prophylactic сentral neck dissection ( n = 41, group A), and the proportion of patients with suspected metastatic lymph nodes more сentral neck dissection was performed ( n = 57, group B). Depending on the calcium concentration postoperative patients in groups A and B were further divided into two subgroups. In one subgroup of postoperative calcium level in the serum was 2.0 mmol/l or less, and in subgroup 2 exceeded2.0 mmol/l. Also, patients were determined in pre- and postoperative levels of 25 (OH) D, parathyroid hormone in the serum.Reults. Using logistic regression analysis showed that factors predictive postoperative hypocalcemia are: preoperative 25 (OH) D - less than 15 ng/ml ( p <0.001), postoperative PTH level in the blood serum - below 10 pg/ml ( p = 0.01).Conclusions. In most cases, age, low preoperative level of 25 (OH) D serum levels and low postoperative PTH level in blood serum is largely associated with the development of postoperative hypocalcemia. Among the factors influencing the development of postoperative hypocalcemia major role in the evaluation group played the volume of surgical intervention - a worst case was a combination of thyroidectomy with сentral neck dissection.

The history of recurrent laryngeal nerve research

A. Burns described thyroid cancer in 1811. History of surgical treatment of thyroid cancer is presented in the article. N. I. Pirogov was the first in the world who performed thyroid resection under general anesthesia in 1847. A. A. Bobrov was the first who started to perform thyroid operations under recurrent nerves visual control since 1893. V. I. Razumovsky was the first who described anaplastic and medullary thyroid carcinomas in 1903. Tactics in thyroid cancer treatment in different country are presented.

Voice Quality After Surgical Treatment for Thyroid Cancer

Thyroidectomy is a standard treatment for thyroid cancers. Hoarseness due to the paralysis of the recurrent laryngeal nerve is one of the most common postoperative complications, and has been studied by many investigators. However, voice quality after thyroidectomy in patients in whom recurrent laryngeal nerves were preserved and vocal cord morbidity was endoscopically normal has not been well studied. To understand voice quality after thyroidectomy further, we conducted a time-course analysis of voice quality in patients who had thyroidectomy with normal cord morbidity by various measures. We evaluated voice parameters including the Voice Handicap Index-10 (VHI-10), the vocal efficacy index, the fundamental frequency (F0), the maximum phonation time (MPT), the mean air flow rate (MFR), jitter, shimmer, and the noise-to-harmonics ratio (NHR) before and after total thyroidectomy (TT) or lobectomy (LO) for thyroid cancers in 110 patients in whom the recurrent laryngeal nerves were preserved without apparent injury and normal vocal cord mobility was confirmed by endoscopic examination. Thirteen patients who underwent parotidectomy were enrolled as controls. Immediately after surgery, significant decreases in MPT (p=0.003) and significant increases in jitters, shimmers, and NHR (p=0.0002, 0.02, and 0.03, respectively) were observed in the patients who underwent TT. In comparison with the controls, jitters and NHR were significantly higher in the patients who had a TT (p=0.03, 0.04). MFR was significantly higher in the patients who had an LO than in the controls (p=0.02). As compared with the patients who had an LO, MPT was significantly shorter (p=0.0004) and MFR and NHR were significantly higher (p=0.004, 0.03) in the patients with a TT. In the patients who had a TT, the MPT immediately after the surgery was significantly longer in the patients who had simultaneously neck dissection (ND) in comparison with the patients who did not have ND. However, all these differences gradually decreased and were not significant at one month after surgery. Our results suggest that TT and ND have a distinct impact on voice quality after surgical treatment for thyroid cancer, probably due to slight and transient nerve conduction disorders induced by the manipulation around recurrent laryngeal nerves and/or laryngeal edema induced by the disturbance of venous and lymphatic drainages. However, these changes appear to be temporary, lasting only a few weeks.

ELABORATION OF A NEW METHOD FOR IMMEDIATE INTRASURGICAL MICROCANCER RESEARCH AND EVALUATION OF ITS EFFECTIVENESS

There is a method of making histological preparations with thin slices of tissue that remainedafter the rapid biopsy (freezing) during surgery for papillary thyroid cancer. The method allows toobtain high quality images and provides the rapid histological examination of tumors of small size(microcancer) avoid diagnostic errors and to determine the optimal tactics surgery. The method ishighly accurate, indispensable and is recommended for routine practice facilities, where the surgicaltreatment of thyroid cancer.