Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting
Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This stud...
Ausführliche Beschreibung
Autor*in: |
Alansari, Hasan [verfasserIn] |
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Englisch |
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2023 |
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Anmerkung: |
© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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Übergeordnetes Werk: |
Enthalten in: Indian journal of otolaryngology and head and neck surgery - New Delhi : Springer, 1950, 76(2023), 1 vom: 13. Okt., Seite 720-725 |
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Übergeordnetes Werk: |
volume:76 ; year:2023 ; number:1 ; day:13 ; month:10 ; pages:720-725 |
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DOI / URN: |
10.1007/s12070-023-04261-8 |
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Katalog-ID: |
SPR054996198 |
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520 | |a Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. | ||
520 | |a Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. | ||
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700 | 1 | |a Alamuddin, Naji |4 aut | |
700 | 1 | |a Sabra, Omar |4 aut | |
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10.1007/s12070-023-04261-8 doi (DE-627)SPR054996198 (SPR)s12070-023-04261-8-e DE-627 ger DE-627 rakwb eng Alansari, Hasan verfasserin (orcid)0000-0002-8036-5573 aut Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. Central neck dissection (dpeaa)DE-He213 Thyroid malignancy (dpeaa)DE-He213 Primary neck dissection (dpeaa)DE-He213 Normocalcemia (dpeaa)DE-He213 Mathur, Nalin aut Ahmadi, Husain aut AlWatban, Zaki Hassan aut Alamuddin, Naji aut Sabra, Omar aut Enthalten in Indian journal of otolaryngology and head and neck surgery New Delhi : Springer, 1950 76(2023), 1 vom: 13. Okt., Seite 720-725 (DE-627)482304308 (DE-600)2181728-5 0973-7707 nnns volume:76 year:2023 number:1 day:13 month:10 pages:720-725 https://dx.doi.org/10.1007/s12070-023-04261-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 76 2023 1 13 10 720-725 |
spelling |
10.1007/s12070-023-04261-8 doi (DE-627)SPR054996198 (SPR)s12070-023-04261-8-e DE-627 ger DE-627 rakwb eng Alansari, Hasan verfasserin (orcid)0000-0002-8036-5573 aut Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. Central neck dissection (dpeaa)DE-He213 Thyroid malignancy (dpeaa)DE-He213 Primary neck dissection (dpeaa)DE-He213 Normocalcemia (dpeaa)DE-He213 Mathur, Nalin aut Ahmadi, Husain aut AlWatban, Zaki Hassan aut Alamuddin, Naji aut Sabra, Omar aut Enthalten in Indian journal of otolaryngology and head and neck surgery New Delhi : Springer, 1950 76(2023), 1 vom: 13. Okt., Seite 720-725 (DE-627)482304308 (DE-600)2181728-5 0973-7707 nnns volume:76 year:2023 number:1 day:13 month:10 pages:720-725 https://dx.doi.org/10.1007/s12070-023-04261-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 76 2023 1 13 10 720-725 |
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10.1007/s12070-023-04261-8 doi (DE-627)SPR054996198 (SPR)s12070-023-04261-8-e DE-627 ger DE-627 rakwb eng Alansari, Hasan verfasserin (orcid)0000-0002-8036-5573 aut Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. Central neck dissection (dpeaa)DE-He213 Thyroid malignancy (dpeaa)DE-He213 Primary neck dissection (dpeaa)DE-He213 Normocalcemia (dpeaa)DE-He213 Mathur, Nalin aut Ahmadi, Husain aut AlWatban, Zaki Hassan aut Alamuddin, Naji aut Sabra, Omar aut Enthalten in Indian journal of otolaryngology and head and neck surgery New Delhi : Springer, 1950 76(2023), 1 vom: 13. Okt., Seite 720-725 (DE-627)482304308 (DE-600)2181728-5 0973-7707 nnns volume:76 year:2023 number:1 day:13 month:10 pages:720-725 https://dx.doi.org/10.1007/s12070-023-04261-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 76 2023 1 13 10 720-725 |
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10.1007/s12070-023-04261-8 doi (DE-627)SPR054996198 (SPR)s12070-023-04261-8-e DE-627 ger DE-627 rakwb eng Alansari, Hasan verfasserin (orcid)0000-0002-8036-5573 aut Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. Central neck dissection (dpeaa)DE-He213 Thyroid malignancy (dpeaa)DE-He213 Primary neck dissection (dpeaa)DE-He213 Normocalcemia (dpeaa)DE-He213 Mathur, Nalin aut Ahmadi, Husain aut AlWatban, Zaki Hassan aut Alamuddin, Naji aut Sabra, Omar aut Enthalten in Indian journal of otolaryngology and head and neck surgery New Delhi : Springer, 1950 76(2023), 1 vom: 13. Okt., Seite 720-725 (DE-627)482304308 (DE-600)2181728-5 0973-7707 nnns volume:76 year:2023 number:1 day:13 month:10 pages:720-725 https://dx.doi.org/10.1007/s12070-023-04261-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 76 2023 1 13 10 720-725 |
allfieldsSound |
10.1007/s12070-023-04261-8 doi (DE-627)SPR054996198 (SPR)s12070-023-04261-8-e DE-627 ger DE-627 rakwb eng Alansari, Hasan verfasserin (orcid)0000-0002-8036-5573 aut Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. Central neck dissection (dpeaa)DE-He213 Thyroid malignancy (dpeaa)DE-He213 Primary neck dissection (dpeaa)DE-He213 Normocalcemia (dpeaa)DE-He213 Mathur, Nalin aut Ahmadi, Husain aut AlWatban, Zaki Hassan aut Alamuddin, Naji aut Sabra, Omar aut Enthalten in Indian journal of otolaryngology and head and neck surgery New Delhi : Springer, 1950 76(2023), 1 vom: 13. Okt., Seite 720-725 (DE-627)482304308 (DE-600)2181728-5 0973-7707 nnns volume:76 year:2023 number:1 day:13 month:10 pages:720-725 https://dx.doi.org/10.1007/s12070-023-04261-8 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 AR 76 2023 1 13 10 720-725 |
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Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency.</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. 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Alansari, Hasan |
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Alansari, Hasan misc Central neck dissection misc Thyroid malignancy misc Primary neck dissection misc Normocalcemia Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting |
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Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting Central neck dissection (dpeaa)DE-He213 Thyroid malignancy (dpeaa)DE-He213 Primary neck dissection (dpeaa)DE-He213 Normocalcemia (dpeaa)DE-He213 |
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Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting |
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Alansari, Hasan Mathur, Nalin Ahmadi, Husain AlWatban, Zaki Hassan Alamuddin, Naji Sabra, Omar |
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outcomes of central neck dissection for papillary thyroid carcinoma in primary versus revision setting |
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Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting |
abstract |
Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
abstractGer |
Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
abstract_unstemmed |
Introduction Surgery in the central compartment after previous thyroidectomy involves an increased risk of injury to critical organs, including the parathyroids and recurrent laryngeal nerve. Contrastingly, primary central neck dissection involves a relatively low operative risk. Objective This study aimed to compare the outcomes of central neck dissection in primary versus revision settings with respect to the lymph node yield and complication rates. Methods This single-center prospective study included patients who underwent primary or revision neck dissection surgery for histologically confirmed thyroid malignancy between January 2018 and January 2022. Results We included 30 patients who underwent total thyroidectomy with primary central neck dissection and 29 patients who underwent central neck dissection following remote thyroidectomy with or without previous central dissection. There was no significant between-group difference in postoperative complications, including permanent hypocalcemia and recurrent laryngeal nerve injury. However, both groups showed a significant postoperative decrease in calcium levels even though calcium and parathyroid hormone levels were within reference range. Conclusion Although many surgeons fear revision central neck dissection, it appears to have similar therapeutic outcomes and complication rates as primary neck dissection for papillary thyroid cancer. Specifically, there were no between-group differences in the lymph node yield, hypoparathyroidism, or recurrent laryngeal nerve paralysis. Patients with normocalcemia showed a significant postoperative reduction in calcium levels, suggesting subclinical parathyroid insufficiency. Key points The incidence of papillary thyroid cancer has increased by times 3-fold from 1975 to 2009 but this could be in part attributed to early detection of the disease and more frequent use of ultrasound imaging and other modalities of detection. Central compartment neck dissection is indicated in cases that have clinically or radiologically significant metastatic lymph nodes usually from a primary thyroid tumor or in an elective setting in advanced thyroid and other high-risk tumors. In a revision setting central or lateral lymph node dissection should be considered when suspecting persistent or recurrent disease, which is defined as central neck nodes sized more than 8 mm and lateral neck nodes are sized more than 10 mm on imaging studies. Revision central neck dissection is associated with increased morbidity and lower lymph node yield however in this study there no significant difference in post-operative complications, such as permanent hypocalcemia, recurrent laryngeal nerve injury between the 2 groups. Both groups in the study showed a significantly lower calcium level on the late postoperative tests when compared to preoperative tests, despite still having calcium and PTH levels within normal levels this may be due to parathyroid insufficiency. © Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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title_short |
Outcomes of Central Neck Dissection for Papillary Thyroid Carcinoma in Primary Versus Revision Setting |
url |
https://dx.doi.org/10.1007/s12070-023-04261-8 |
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Mathur, Nalin Ahmadi, Husain AlWatban, Zaki Hassan Alamuddin, Naji Sabra, Omar |
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score |
7.3996534 |