Step-by-step illustrated guide to central neck dissection

Abstract Background The incidence of thyroid carcinoma has been increasing worldwide and surgery is the primary treatment. Central compartment dissection of the neck is a very delicate procedure given the risks of recurrent laryngeal nerve injury and hypoparathyroidism. Methods This paper gives a detailed description of this surgical technique in a patient affected by papillary carcinoma of the thyroid gland, supported by highly representative iconographic materials from a tertiary department. Results A stepwise description is provided, along with high-quality pictures and specific tips and tricks. Although neck dissection is a well-codified procedure, the fine details of this surgical technique are not currently available and are still the prerogative of the expert surgeon. Conclusion The central neck compartment contains several vulnerable structures; damage to these structures would affect patients’ lives, possibly permanently. Anatomical knowledge and standardisation are needed for all surgeons, particularly new surgeons (such as residents) who cannot rely simply on experience.

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Lymph Node Ratio of the Central Compartment is a Significant Predictor for Locoregional Recurrence After Prophylactic Central Neck Dissection in Patients with Thyroid Papillary Carcinoma

Annals of Surgical Oncology ◽

10.1245/s10434-013-3258-1 ◽

2013 ◽

Vol 21 (1) ◽

pp. 277-283 ◽

Cited By ~ 49

Author(s):

In Sun Ryu ◽

Chan Il Song ◽

Seung-Ho Choi ◽

Jong-Lyel Roh ◽

Soon Yuhl Nam ◽

...

Keyword(s):

Lymph Node ◽

Neck Dissection ◽

Locoregional Recurrence ◽

Lymph Node Ratio ◽

Central Compartment ◽

Central Neck Dissection ◽

Central Neck ◽

Prophylactic Central Neck Dissection ◽

Thyroid Papillary ◽

Node Ratio

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Transoral robotic-assisted thyroidectomy with central neck dissection: preclinical cadaver feasibility study and proposed surgical technique

Journal of Robotic Surgery ◽

10.1007/s11701-011-0287-2 ◽

2011 ◽

Vol 5 (4) ◽

pp. 279-282 ◽

Cited By ~ 59

Author(s):

Jeremy D. Richmon ◽

F. Christopher Holsinger ◽

Emad Kandil ◽

Michael W. Moore ◽

Jose Armando Garcia ◽

...

Keyword(s):

Surgical Technique ◽

Neck Dissection ◽

Feasibility Study ◽

Central Neck Dissection ◽

Central Neck ◽

Robotic Assisted

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Effect of central compartment neck dissection on hypocalcaemia incidence after total thyroidectomy for carcinoma

The Journal of Laryngology & Otology ◽

10.1017/s0022215110002471 ◽

2010 ◽

Vol 125 (5) ◽

pp. 497-501 ◽

Cited By ~ 11

Author(s):

I Mitra ◽

J R Nichani ◽

B Yap ◽

J J Homer

Keyword(s):

Thyroid Carcinoma ◽

Total Thyroidectomy ◽

Neck Dissection ◽

Survival Benefit ◽

Central Compartment ◽

Differentiated Thyroid Carcinoma ◽

Central Neck Dissection ◽

Elective Neck Dissection ◽

Central Neck ◽

High Expectation

AbstractIntroduction:Central compartment neck dissection is increasingly performed as part of surgical management of differentiated thyroid carcinoma. However, elective central neck dissection remains controversial due to complications and lack of evidence of survival benefit.Objective:To investigate and compare rates of transient and permanent hypocalcaemia following total thyroidectomy alone, compared with total thyroidectomy with central neck dissection, for differentiated thyroid carcinoma.Methods:Retrospective study of 127 consecutive patients referred with differentiated thyroid carcinoma, 2004–2006; 78 patients had undergone total thyroidectomy (group one) and 49 total thyroidectomy with central compartment node dissection (group two). Surgery was performed in various hospitals by both otolaryngologists and endocrine surgeons.Results:In groups one and two, the incidence of transient hypocalcaemia was 18 per cent (14/78) and 51 per cent (25/49) (p < 0.001), and the incidence of permanent hypocalcaemia 1 per cent (one of 77) and 12 per cent (six of 49) (p < 0.01), respectively. Most patients undergoing central neck dissection had evidence of pathological level six lymphadenopathy (29/49).Conclusion:Total thyroidectomy combined with central neck dissection for the treatment of differentiated thyroid carcinoma is more likely to result in transient (51 per cent) and permanent (12 per cent) hypocalcaemia. Elective neck dissection should be performed selectively, with a high expectation of post-operative hypocalcaemia.

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The Effect of Prophylactic Central Neck Dissection During Hemithyroidectomy on Locoregional Recurrence in Patients With Papillary Thyroid Carcinoma: A Meta-Analysis

Clinical and Experimental Otorhinolaryngology ◽

10.21053/ceo.2019.01634 ◽

2020 ◽

Vol 13 (2) ◽

pp. 194-202 ◽

Cited By ~ 4

Author(s):

Soon-Hyun Ahn ◽

Won Sik Kim

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Neck Dissection ◽

Locoregional Recurrence ◽

Meta Analysis ◽

Central Compartment ◽

Central Neck Dissection ◽

Central Neck ◽

Papillary Thyroid ◽

Prophylactic Central Neck Dissection

Objectives. Hemithyroidectomy is commonly performed in patients with low- to intermediate-risk papillary thyroid carcinoma. The purpose of this meta-analysis was to evaluate the effect of prophylactic central neck dissection on locoregional recurrence in patients undergoing hemithyroidectomy.Methods. A meta-analysis was performed of full-text publications published in English retrieved from the Embase database.Results. The rate of regional recurrence in the central compartment after hemithyroidectomy, with or without prophylactic central neck dissection, was 0.17% and 1.78%, respectively. This difference was statistically significant. Recurrence in the lateral compartment or contralateral thyroid was not affected by prophylactic central neck dissection; the overall rate of recurrence was 1.3% and 5.4%, respectively.Conclusion. Prophylactic central neck dissection significantly reduced the risk of recurrence in the central compartment in patients undergoing hemithyroidectomy.

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