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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Role of prophylactic ipsilateral central compartment lymph node dissection in papillary thyroid microcarcinoma
Mujgan Caliskan1, Jae Hyun Park, Jun Soo Jeong
1Department of General Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey.
Endocrine Journal
|January 14, 2012
Summary
Prophylactic ipsilateral central compartment lymph node dissection (PI-CCND) is safe and feasible for papillary thyroid microcarcinoma (PTMC) patients. This procedure accurately stages disease and prevents lymph node recurrence, even without initial signs of metastasis.
Area of Science:
- Endocrinology
- Surgical Oncology
- Thyroid Cancer Research
Background:
- Management of central compartment lymph nodes (CCLN) in papillary thyroid microcarcinoma (PTMC) without metastasis is controversial.
- Accurate staging and risk stratification are crucial for optimal PTMC patient outcomes.
Purpose of the Study:
- To evaluate the outcomes of prophylactic ipsilateral central compartment lymph node dissection (PI-CCND) in PTMC patients.
- To assess the safety and efficacy of PI-CCND in determining lymph node status and preventing recurrence.
Main Methods:
- Retrospective cohort study of 842 PTMC patients undergoing thyroid surgery with PI-CCND between 2000-2005.
- Inclusion criteria: PTMC, no clinical/radiologic CCLN metastasis, ≥60 months follow-up.
- Analysis of metastasis rates, complications, and recurrence patterns.
Main Results:
- Ipsilateral CCLN metastasis detected in 25.9% of patients.
- Low complication rates: transient hypoparathyroidism (9%), permanent hypoparathyroidism (2.6%), vocal cord palsy (0.5%), bleeding (0.1%).
- No CCLN recurrence observed in patients who underwent PI-CCND; recurrence rate was 2.26% overall.
Conclusions:
- PI-CCND is technically feasible and safe for PTMC.
- PI-CCND improves disease staging and risk stratification.
- PI-CCND should be considered even with negative clinical or radiological findings for CCLN metastasis.
