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Master Thesis

Étude de l'intérêt de l'examen extemporané dans la chirurgie thyroïdienne

Abstract : Introduction: The use of intraoperative frozen section (FS) during thyroid surgery is still controversial. We aimed to evaluate the performances of FS for the diagnosis of malignancy according to ultrasound and cytology results. Methods: 176 consecutive patients who underwent thyroid surgery with FS between October 2017 and December 2019 were reviewed. All patients underwent neck ultrasound and fine-needle aspiration in our hospital. The performances of FS was assessed using sensitivity (Se), specificity (Sp), positive (PPV) and negative (NPV) predictive values. Results: Of the 180 thyroid nodules, 36 (20%) were malignant, including 19 with a positive FS. Among the 10 malignant nodules with pathology displaying follicular cancers, follicular variant of papillary cancers and poorlydifferentiated subtypes, FS was negative in 7. Se, Sp, PPV and NPV were 52.8%, 99.3%, 95% and 89.2% in the whole population, 20%, 100%, 100% and 89% respectively in nodules scored Bethesda III/IV and 33,3%, 100%, 100% and 86.7% respectively in nodules scored TIRADS 4A, and 28.6%, 100%, 100% and 88,4% respectively in nodules ≥ 4 cm. Mean time of FS was 22 ±7 minutes. Conclusion: FS has low performance for detection of thyroid malignancy, particularly in nodules with indeterminate cytology and in follicular subtypes. These results might lead to abandon its routine use in our department.
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Master Thesis
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Submitted on : Monday, February 28, 2022 - 11:50:36 AM
Last modification on : Saturday, April 9, 2022 - 3:43:43 AM


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Pauline Geraldy. Étude de l'intérêt de l'examen extemporané dans la chirurgie thyroïdienne. Médecine humaine et pathologie. 2021. ⟨dumas-03590974⟩



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