[Development and reflection on the scope and indications of central lymph node dissection for differentiated thyroid...

Differentiated thyroid cancer (DTC) is prone to central lymph node metastasis. Current guidelines and consensus explicitly state that the central lymph node range for thyroid cancer includes regions Ⅵ and Ⅶ. However,there is still controversy regarding the implementation of prophylactic central lymph node dissection(pCND) in DTC patients who have no lymph node metastasis detected by preoperative clinical examination and intraoperative exploration. Although the role of pCND in long-term survival,recurrence rate,and postoperative thyroglobulin levels in cN0 DTC patients remains unclear,it can effectively remove potentially metastatic lymph nodes in the central area. This not only helps to enhance the thoroughness of the surgery but also reduces the potential complications of reoperation. According to the "Diagnosis and treatment guidelines for thyroid nodules and differentiated thyroid cancer(second edition)" from 2023 and the general opinion of domestic scholars, it is recommended to perform pCND on the same side as the lesion for cN0 DTC patients. When performing pCND, it is crucial to maintain the accuracy of the surgical scope to minimize the risk of postoperative complications.