What are the conditions and methods of thyroid cancer surgery?
Jul 08, 2024
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Thyroid cancer is relatively common among various cancer diseases. In fact, according to the 2021 National Cancer Registration Statistics released by the National Cancer Center, the incidence of thyroid cancer is 68.6 per 100,000 people, ranking first for three consecutive years. It also means that there are not a few people suffering from thyroid cancer regardless of gender, and the prognosis is better than other cancers, as the survival rate reaches 98 percent when operated in the early stages.
The problem is that as the thyroid gland is an organ located in the front of the neck, surgical scars are relatively easy to be exposed to the outside. In fact, many people always cover their scars with scarves or scarves after thyroid surgery.
Yoon Yeo-kyu, director of the Thyroid Center at Gangnam Bedro Hospital, explained, "The basic treatment for thyroid cancer is thyroid resection, and many patients suffer from scarring even after recovery as the previously mainly performed surgical method directly cuts the skin."
What are the surgical methods that can treat thyroid cancer 'without scars' and in what cases such surgery will be possible were summarized with the help of Yoon Yeo-kyu, director of the Thyroid Center at Gangnam Bedro Hospital.
▶ Cancer is suspected if the thyroid gland grows bigger or there is pressure on the neck
Where the thyroid gland is located is the thyroid cartilage protruding from the front of the neck, that is, 2 to 3cm below the uvula. The development of a lump in the thyroid gland is called thyroid nodule, and about 5-10% of all thyroid nodule patients are diagnosed with thyroid cancer.
Director Yoon Yeo-kyu explained, "The thyroid nodule itself is a very common disease that is found at about 30% frequency during ultrasound examination, and most of them have no symptoms and are found by accident through ultrasound examination." "However, if the nodule suddenly grows, there is pressure on the neck, voice changes or shortness of breath, a thorough examination of thyroid cancer through ultrasound and fine-needle aspiration tests is required."
If it is diagnosed as thyroid cancer, it first goes through the process of distinguishing the type of cancer. Thyroid cancer is largely divided into four types: ▲ papilla cancer ▲ follicle cancer ▲ watery cancer ▲ undifferentiated cancer and anaplastic cancer. Most thyroid cancers correspond to papillary and follicular cancers, and they have a relatively good prognosis when treated.
Thyroid papillary cancer (PTC), which accounts for 75-80% of all thyroid cancers, is a cancer in which tumors grow together and progress very slowly. The 10-year survival rate is also over 90%, and most of them can recover daily without problems after treatment. Follicular carcinoma, which accounts for 20% of all thyroid cancers, also has a good prognosis due to slow growth of cancer cells. On the other hand, medullary cancer, undifferentiated cancer, and anaplastic cancer are rare at 0.2 to 1% of all thyroid cancers, but the prognosis is poor due to rapid metastasis and cancer cell growth. In particular, in the case of undifferentiated cancer, the risk is high enough to be classified into stage 4 at the same time as diagnosis.
Director Yoon Yeo-gyu emphasized that `Although thyroid cancer has a relatively good prognosis, it is important to comprehensively diagnose the type and metastasis of cancer through a specialist and receive appropriate treatment.'
All thyroid cancer treatments are based on surgical treatment, but the scope of surgery and treatment methods may vary somewhat depending on the patient's condition. Generally, according to the scope of the operation, it is divided into 'pre-excision' that cuts the entire thyroid gland and 'lobectomy' that cuts only the lobes with tumors, and in some cases, 'pre-excision' that leaves part of the thyroid gland, and 'Cervical Lymphectomy' that removes the surrounding lymph nodes are also performed. If necessary, radioactive iodine treatment may be added after surgery. This treatment process is determined through sufficient preoperative examination and consultation with a thyroid specialist.
▶Various surgeries that minimize scarring, such as BABA endoscopy and oral ocular endoscopy
After the scope of surgery is determined, the surgical method is decided. Thyroid cancer surgery is largely divided into skin incision and endoscopic surgery. Cervical incision, which is performed by cutting 4-5cm of skin under the umbilical cord, is one of the traditional surgical methods that has been performed for a long time, and although it can be performed regardless of the degree of cancer progression, there was a fatal disadvantage of leaving a scar in the front of the neck, so patients were worried.
It is endoscopic resection that can solve these concerns. BABA (bilateral fluid and breast approach) endoscopic surgery, developed for the first time in the world in 2004 by director Yoon Yeo-gyu, is one of the widely distributed surgical methods. The operation is carried out by inserting an endoscope into both armpits and rings of less than 1 cm and then approaching the lesion. In addition to reducing the burden of scarring, it does not affect lactation and breast cancer screening at all.
In addition, the recently devised oral perihepatic endoscopy method is a 'scarpless surgery method' designed to take this one step further and not leave scars at all. Three micro-incisions are performed on the mucous membrane between the lower body and lips, and then an endoscope is inserted to perform surgery. The oral mucosa has a very rapid rate of wound recovery and leaves little scarring after recovery. Since there are no skin wounds, it is possible to take a shower immediately after surgery, it is easy to return to daily life, and the risk and pain of skin adhesion are relatively small, so patient satisfaction is very high.
However, not all thyroid cancer patients can undergo endoscopic resection. The availability of endoscopic surgery depends on the location and size of the cancer and the risk of metastasis.
Director Yoon Yeo-gyu advised, "The smaller the size of cancer and the lower the risk of metastasis, the higher the likelihood of endoscopic surgery, and the better the prognosis of surgery."Since the scope of surgery and whether the surgical method is applied may vary widely depending on the patient's condition, it is recommended to consult a specialist with extensive thyroid surgery and treatment experience as much as possible."
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