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Selection of irrigation fluid to eradicate free cancer cells during head and neck cancer surgery
Hah, J. Hun,Roh, Dong Hwan,Jung, Young Ho,Kim, Kwang Hyun,Sung, Myung‐,Whun Wiley Subscription Services, Inc., A Wiley Company 2012 Head & Neck Vol.34 No.4
<P><B>Abstract</B></P><P><B>Background</B></P><P>Free cancer cells can be spilled out from exposed tumors or ruptured tumors. We examined the cytocidal effect of various irrigation fluids on free cancer cells in an animal wound model mimicking head and neck surgery.</P><P><B>Methods</B></P><P>Cancer cell–contaminated wounds were made with C3H/HeJ mice and syngeneic squamous cell carcinoma (SCC VII) cells. Distilled water, 5% povidone–iodine, 1.5% H<SUB>2</SUB>O<SUB>2</SUB>, normal saline, and cisplatin were used to irrigate for 5 minutes. In vitro tumor growth assays were done with different concentrations and exposure times of povidone–iodine and distilled water.</P><P><B>Results</B></P><P>In the animal study, povidone–iodine significantly inhibited tumor growth. Povidone–iodine caused substantial inhibition of in vitro tumor growth, even at the concentration of 0.05%. After 30 seconds of exposure to 1% povidone–iodine, cancer cells were completely inhibited.</P><P><B>Conclusions</B></P><P>Povidone–iodine could be selected preferentially for the irrigation fluid during head and neck surgery, especially when the wound is suspected of cancer cell contamination. © 2011 Wiley Periodicals, Inc. Head Neck, 2012</P>
갑상선전절제술과 중심경부절제술을 시행한 환자에서 부갑상선 자가이식의 결과
하정훈 ( J. Hun Hah ),최효근 ( Hyo Geun Choi ),성명훈 ( Myung-whun Sung ),김광현 ( Kwang Hyun Kim ) 대한갑상선학회 2008 International Journal of Thyroidology Vol.1 No.1
Background and Objectives: Hypoparathyroidism is an important complication after total thyroidectomy, especially with central neck dissection. Although parathyroid gland autotransplantation (PTGAT) during thyroidectomy has been shown to reduce the incidence of permanent hypoparathyroidism, the value of the procedure during central neck dissection combined with thyroidectomy has not been reported well. Materials and Methods: Operative principles include preservation of parathyroid glands in situ and autotransplantation of parathyroid glands inadvertently resected or devascularized during operation. Seventy-nine patients were included in this study. Among 44 patients underwent total thyroidectomy only, 25 patients underwent PTGAT. Among 35 patients received total thyroidectomy with central neck dissection, 26 patients underwent PTGAT. Immediate hypocalcemia was defined as the case with symptomatic hypocalcemia, requiring calcium supplementations. Permanent hypoparathyroidism was defined as the case with iPTH level below 10 pg/ml at postoperative 3<sup>rd</sup> month. Results: Thirty four patients (43.0%) showed immediate hypocalcemia and 7 patients (8.9%) showed permanent hypoparathyroidism. Central neck dissection is the most important risk factor of immediate hypocalcemia (p=0.011). Though PTGAT didn't affect outcomes in the patients underwent thyroidectomy only, it could partly reduce permanent hypoparathyroidism in the patients underwent central neck dissection combining total thyroidectomy (p=0.095). Conclusion: PTGAT might be helpful during total thyroidectomy with central neck dissection. To get better outcomes, technical improvement in surgical dissection and PTGAT may be needed.