Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-20T09:22:16.974Z Has data issue: false hasContentIssue false

Step-by-step illustrated guide to central neck dissection

Published online by Cambridge University Press:  01 October 2021

F Chu
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’), Milan, Italy
R De Berardinis*
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’), Milan, Italy
G Pietrobon
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’), Milan, Italy
M Tagliabue
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’), Milan, Italy
G Giugliano
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’), Milan, Italy
M Ansarin
Affiliation:
Department of Otorhinolaryngology and Head and Neck Surgery, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (‘IRCCS’), Milan, Italy
*
Author for correspondence: Dr Rita De Berardinis, Department of Otolaryngology and Head and Neck Surgery, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141Milano, Italy E-mail: [email protected]

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.

Type
Short Communications
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr R De Beradinis takes responsibility for the integrity of the content of the paper

References

Cabanillas, ME, McFadden, DG, Durante, C. Thyroid cancer. Lancet 2016;388:2783–95CrossRefGoogle ScholarPubMed
Haugen, BR, Alexander, EK, Bible, KC, Doherty, GM, Mandel, SJ, Nikiforov, YE et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid 2016;26:1133CrossRefGoogle ScholarPubMed
Sancho, JJ, Lennard, TW, Paunovic, I, Triponez, F, Sitges-Serra, A. Prophylactic central neck dissection in papillary thyroid cancer: a consensus report of the European Society of Endocrine Surgeons (ESES). Langenbecks Arch Surg 2014;399:155–63CrossRefGoogle Scholar
Feng, JW, Pan, H, Wang, L, Ye, J, Jiang, Y, Qu, Z. Determine the optimal extent of thyroidectomy and lymphadenectomy for patients with papillary thyroid microcarcinoma. Front Endocrinol (Lausanne) 2019;10:363CrossRefGoogle ScholarPubMed
Orloff, LA, Kuppersmith, RB. American Thyroid Association's central neck dissection terminology and classification for thyroid cancer consensus statement. Otolaryngol Head Neck Surg 2010;142:45CrossRefGoogle ScholarPubMed
Robinson, TJ, Thomas, S, Dinan, MA, Roman, S, Sosa, JA, Hyslop, T. How many lymph nodes are enough? Assessing the adequacy of lymph node yield for papillary thyroid cancer. J Clin Oncol 2016;34:3434–9CrossRefGoogle ScholarPubMed
Randle, RW, Balentine, CJ, Leverson, GE, Havlena, JA, Sippel, RS, Schneider, DF et al. Trends in the presentation, treatment, and survival of patients with medullary thyroid cancer over the past 30 years. Surgery 2017;161:137–46CrossRefGoogle ScholarPubMed
Patel, KN, Yip, L, Lubitz, CC, Grubbs, EG, Miller, BS, Shen, W et al. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Ann Surg 2020;271:e2193CrossRefGoogle Scholar
Mitchell, AL, Gandhi, A, Scott-Coombes, D, Perros, P. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016;130:S150–60CrossRefGoogle ScholarPubMed
Roman, BR, Randolph, GW, Kamani, D. Conventional thyroidectomy in the treatment of primary thyroid cancer. Endocrinol Metab Clin North Am 2019;48:125–41CrossRefGoogle ScholarPubMed