Why is the thyroid cancer incision not cleaned cleanly?

The possible reasons for incomplete cleaning of the surgical incision of thyroid cancer include large tumor volume, a large number of lymph node metastases, invasion of surrounding tissues and organs, etc. The main surgical method for thyroid cancer is thyroid lobectomy and isthmus resection. After surgery, radiotherapy, endocrine therapy, and chemoradiotherapy can be further performed according to the pathological results.

1. Large tumor volume: If the thyroid cancer tumor volume is relatively large, it is likely that the tumor cannot be completely removed during surgery, and some tumor tissue may remain. In this case, a second surgery or thyroid lobectomy plus isthmus resection can be considered. Rapid pathological examination is required during the operation to further clarify whether the resection margin is negative;

2. A large number of lymph node metastases: During the operation, if there are a large number of lymph node metastases, they may not be cleaned cleanly, resulting in incomplete lymph node dissection. The patient needs to be treated with iodine-131 or targeted therapy after the operation, and the treatment plan needs to be selected according to the specific condition;

3. Invasion of surrounding tissues and organs: If thyroid cancer lesions invade the surrounding trachea, esophagus, recurrent laryngeal nerve, etc., the lesion tissue cannot be completely removed during surgery, which may cause residual lesion tissue. If the pathological results indicate a malignant tumor, it is necessary to expand the scope of resection, and assist with postoperative radiotherapy, endocrine therapy, radiotherapy and chemotherapy, etc.

Patients with poor physical fitness, who cannot tolerate surgery, or who are unwilling to undergo secondary surgery, can simply undergo radiotherapy or chemotherapy. After active treatment, patients with thyroid cancer usually have a better prognosis and can also improve their quality of life. However, even if patients with thyroid cancer undergo surgery, they still need to regularly review their thyroid function and thyroid color Doppler ultrasound.