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Annals of Surgical Oncology

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Open Access 01-11-2016 | Endocrine Tumors

Prophylactic “First-Step” Central Neck Dissection (Level 6) Does Not Increase Morbidity After (Total) Thyroidectomy

Authors: Andreas Selberherr, MD, Philipp Riss, MD, Christian Scheuba, MD, Bruno Niederle, MD

Published in: Annals of Surgical Oncology | Issue 12/2016

Abstract

Background

In terms of morbidity, prophylactic central neck dissection (CND; level 6) in potentially malignant thyroid disease is discussed controversially. The rates of (transient and permanent) hypoparathyroidism and palsy of the recurrent laryngeal nerve (RLN) after “first-step” (FS-)CND are analyzed in this study.

Methods

Bilateral and unilateral FSCND, i.e., lymph node dissection along the RLN before (total) thyroidectomy, was performed bilaterally in 68 (group 1) and unilaterally in 44 patients (group 2), respectively. The rates of hypoparathyroidism and palsy of the RLN were documented prospectively and were compared to 237 patients of group 3 (controls) who underwent (total) thyroidectomy only.

Results

Fifteen of 68 patients (22 %) of group 1 developed transient and one patient had permanent hypoparathyroidism. Transient unilateral palsy of the RLN was observed in ten patients (15 %); none were permanent. Transient hypoparathyroidism was monitored in 10 of 44 patients (23 %) of group 2 and permanent hypoparathyroidism in 1 (2 %). Six patients (14 %) developed temporary palsy of the RLN; one remained permanent. Palsy was seen in 3 patients on the contralateral side of unilateral FSCND. Transient and permanent hypoparathyroidism was observed in 50 (21 %) and 2 (1 %) of 237 controls. Transient palsy of the RLN was documented in 22 (9 %) of 237 controls and permanent palsy of the RLN in 4 (2 %).

Conclusions

In this single-center series, the overall permanent morbidity was low (1 %). Therefore, FSCND may be recommended (even prophylactically) for experienced high-volume surgeons in patients with thyroid nodules suspicious for malignancy.

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Title: Prophylactic “First-Step” Central Neck Dissection (Level 6) Does Not Increase Morbidity After (Total) Thyroidectomy
Authors: Andreas Selberherr, MD
Philipp Riss, MD
Christian Scheuba, MD
Bruno Niederle, MD
Publication date: 01-11-2016
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 12/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-016-5338-5

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Prophylactic “First-Step” Central Neck Dissection (Level 6) Does Not Increase Morbidity After (Total) Thyroidectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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