title: Minimally-invasive endoscopically-assisted neck dissection for lateral cervical metastases of thyroid papillary carcinoma.
abstract: Traditional open operations for lateral neck dissection in patients with papillary thyroid carcinoma leave an unsightly scar. We report complete lateral neck dissection and thyroidectomy for papillary thyroid carcinoma using an endoscopically-assisted approach through a small incision, and evaluate its feasibility and safety. Between March 2010 and January 2013, 6 patients with no definite metastases to the lymph nodes at levels II-IV, and 20 with definite metastases to the lymph nodes at levels II-V were selected. Thyroidectomy, dissection of the central compartment (level VI), and ipsilateral level II-IV and II-V neck dissections were done through a small incision in the neck. The steps of endoscopic lateral neck dissection were similar to those of conventional operations. The mean operating time for the whole procedure was 3.57 hours (range 2.5 - 5.0). It was successful in all patients and there were no serious complications or serious blood loss. A total of 21 patients had lymph node metastases in the central and lateral zones. The mean yield of lymph nodes was 38.6 (range 16-61). There was no evidence of residual or recurrent disease at follow-up, and the cosmetic result was excellent. Minimally invasive, video-assisted comprehensive neck dissection for metastatic papillary thyroid carcinoma is feasible and safe, and has excellent cosmetic results. Further studies with a larger number of patients and long-term follow-up are needed to verify its oncological validity.
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: velupillai.ilankovan@poole.nhs.uk.
authors.forename: Zongmin
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Zhengang
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Zhengjiang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Changming
authors.initials: C
authors.lastname: An
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Song
authors.initials: S
authors.lastname: Ni
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Pingzhang
authors.initials: P
authors.lastname: Tang
authors.affiliation: Poole Hospital NHS Foundation Trust, Poole, Dorset, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Sayan
authors.affiliation: Poole Hospital NHS Foundation Trust, Poole, Dorset, UK.
authors.forename: Velupillai
authors.initials: V
authors.lastname: Ilankovan
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000556:secondary* / Q000601:surgery; D002291:Carcinoma, Papillary; D004210:Dissection / Q000379:methods; D004954:Esthetics; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D037981:Neck Dissection / Q000379:methods*; D009334:Neck Muscles / Q000294:innervation / Q000601:surgery; D009367:Neoplasm Staging; D061646:Operative Time; D012449:Safety; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*
keywords: Thyroid; endoscopy; neck dissection; papillary carcinoma