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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
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Quality Indicators of Central Compartment Neck Dissection in Thyroid Surgery
Alexandra E Quimby1, Martin J Corsten2, Elysia Grose3
1Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada.
Summary
Thyroidectomy central compartment lymph node dissection (CCLND) often yields few lymph nodes. The study found no significant link between lymph node count and hypocalcemia, but more data is needed.
Area of Science:
- Endocrine Surgery
- Surgical Quality Improvement
Background:
- Quality metrics are crucial for enhancing patient care in surgery.
- Variability in lymph node yield during central compartment lymph node dissection (CCLND) for thyroidectomy is not well-documented.
Purpose of the Study:
- To investigate the number of lymph nodes removed during CCLND in thyroidectomy.
- To assess the association between lymph node yield and postoperative hypocalcemia.
Main Methods:
- Retrospective cohort study utilizing American College of Surgeons National Quality Improvement Program (ACS-NSQIP) data.
- Inclusion of adult patients undergoing thyroidectomy with or without CCLND from North American and global centers.
Main Results:
- A total of 6108 patients were analyzed, with 1565 undergoing CCLND.
- The median lymph node yield for CCLND was 2 nodes.
- No statistically significant association was found between CCLND and postoperative hypocalcemia, though the study was underpowered.
Conclusions:
- Many documented CCLND procedures during thyroidectomy result in a low number of removed lymph nodes.
- The limited yield of CCLND in many cases restricts definitive conclusions about its impact on postoperative hypocalcemia.
