A less invasive, selective, functional neck dissection for papillary thyroid carcinoma.
OBJECTIVE
To describe an alternative lateral neck access in order to perform neck dissection in papillary thyroid carcinoma (PTC) with lymph node involvement.


METHODS
Prospective (January 2000 to December 2003), 36-month study.


METHODS
Catholic University of Rome and University of "Tor Vergata", Rome, Italy.


METHODS
Twenty-four consecutive patients with PTC and cervical lymph node metastases were included. Functional neck dissection (FND), unilateral or bilateral, was performed acceding via a lateral dissection through a traditional Kocher incision, running along the superficial fascia of the neck and posteriorly to the sternocleidomastoideus muscle.


RESULTS
Mean age was 39.04+/-13.69 years. Twenty patients were women and four were men. Mean tumour size was 2.5+/-1 cm, while the greatest metastatic lymph node size was 4.5 cm. Minimally invasive, selective FND was performed in all patients associated to total thyroidectomy and central compartment lymph node clearance. Metastatic lymph nodes were found in 142 out of 340 of the lymph nodes dissected.


CONCLUSIONS
Minimally invasive neck dissection seems to carry a lower risk in terms of specific morbidity and allows a quicker recovery and a better aesthetic result. This access has to be considered as a less invasive procedure compared to the other surgical accesses for the radical or modified lateral neck dissection.
Ardito
G
G
Department of Surgery, Catholic University of Sacred Heart, Rome, Italy. arditog@libero.it
Rulli
F
F
Revelli
L
L
Moschella
F
F
Galatà
G
G
Giustozzi
E
E
Ardito
F
F
Farinon
A M
AM
D000328:Adult; D002291:Carcinoma, Papillary / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D037981:Neck Dissection / Q000379:methods*; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy