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Published on: September 15, 2023
Cervical neck dissection without drains in well-differentiated thyroid carcinoma
Bassam Abboud1, Ghassan Sleilaty, Jenny Tannoury
1Department of General Surgery, Hotel Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. dbabboud@yahoo.fr
The American Surgeon
|January 26, 2012
Summary
Thyroidectomy with or without neck dissection without drainage is safe for well-differentiated thyroid carcinoma (WDTC). This approach showed low complication rates and short hospital stays, proving effective for WDTC treatment.
Area of Science:
- Oncology
- Surgical Oncology
- Endocrine Surgery
Background:
- Well-differentiated thyroid carcinoma (WDTC) is the most common type of thyroid cancer.
- Surgical management often involves thyroidectomy, potentially with cervical lymph node dissection.
- The use of surgical drains after these procedures is a topic of ongoing discussion regarding safety and efficacy.
Purpose of the Study:
- To evaluate the safety and effectiveness of thyroidectomy combined with cervical neck dissection without drainage in patients with WDTC.
- To compare complication rates and length of stay between patients undergoing thyroidectomy with and without neck dissection, all without drainage.
Main Methods:
- Retrospective review of medical records of patients with WDTC who underwent thyroidectomy without drainage.
- Patients were categorized into three groups: thyroidectomy with central neck dissection (Group 1), thyroidectomy with central and lateral neck dissection (Group 2), and thyroidectomy without neck dissection (Group 3).
- Analysis of postoperative complications including hematoma, seroma, hypocalcemia, hypoparathyroidism, and vocal cord issues, as well as length of hospital stay.
Main Results:
- Overall, 5% of patients experienced postoperative hematoma and/or seroma, with similar rates across all groups (6% in Group 1, 7% in Group 2, 5% in Group 3).
- Complications were generally minor and did not require surgical intervention.
- Transient hypocalcemia occurred in 23% of patients, permanent hypoparathyroidism in 1%, transient hoarseness in 6%, and permanent vocal cord paralysis in 0.6%.
- The majority of patients (91%) had a postoperative stay of only 1 day.
- Groups 1 and 2 (with neck dissection) showed no increased perioperative local complications or length of stay compared to Group 3 (without neck dissection).
Conclusions:
- Thyroidectomy combined with cervical neck dissection without drainage is a safe and effective surgical approach for well-differentiated thyroid carcinoma.
- The absence of drains does not increase the risk of significant local complications or prolong hospitalization in WDTC patients undergoing neck dissection.
- This surgical strategy offers a favorable outcome with minimal morbidity and short hospital stays.
