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[Central cervical dissection of lymph nodes in the management of differentiated thyroid carcinoma--our experience]
1Klinika onkologickej chirurgie LF UKo, Onkologický ustav sv. Alzbety, Bratislava, Slovenská republika.
Introduction:
Total thyroidectomy (TTE) with central compartment lymphonodes (LU) dissection remains a standard procedure in the treatment of differentiated thyroid carcinomas.
Methodology:
The retrospective study assessed a group of patients undergoing primary or secondary procedures in our clinic.
Patient Group:
From 01.01. 2005 to 31. 07. 2007, a total of 50 patients underwent primary procedures, TTE with dissection of central compartment lymphonodes was performed in 18 patients, 58 patients were reoperated for relapses of the disorder. In the primary procedures, the central compartment lymphonodes were affected with increased rate, proportionally to a T-stage of the disorder 28% (T1), 52 (T2), 58% (T3). Multifocal carcinoma was associated with a high risk, where metastatic lymphadenopathy occured in 53% of the cases. In the reoperated subjects, relapses of the disorder were recorded in 78% of the patients in their central compartment lymphonodes and their thyreoglobulin levels decreased. Out of 126 patients, paresis of the nervus laryngeus reccurens was recorded in 4 subjects (3.1%) and postoperative hypoparathyreosis in 14 subjects (11%).
Conclusion:
Dissection of lymphonodes is a standard part of the surgical management of differentiated carcinomas, providing local control of the disease. 78% of the relapses were located within the central compartment. Risk and complication rates correspond to those reported in total thyroidectomy.
