title: Technical hints and potential pitfalls in modified radical neck dissection for thyroid cancer.
abstract: Modified radical neck dissection (MRND) is often performed in conjunction with total thyroidectomy for the management of thyroid cancer. Prevention of postoperative sequelae after MRND is closely dependent on the avoidance of technical mistakes that may lead to significant complications and long-term morbidity. A thorough technical discussion with emphasis on potential pitfalls is made of the most relevant steps of MRND using the extrafascial approach: fascial dissection, approach to the accessory nerve, posterior limits, upper internal jugular vein (IJV), transverse cervical vessels, thoracic duct and compartment V dissection. Some anatomical hints are emphasized to help the novice surgeon to develop a refined surgical technique, the key to an uneventful postoperative course.
authors.affiliation: Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Sitges-Serra
authors.affiliation: Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain.
authors.forename: Leyre
authors.initials: L
authors.lastname: Lorente
authors.affiliation: Endocrine Surgery Unit, Hospital del Mar, Barcelona, Spain.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Sancho
keywords: Neck dissection; landmarks; papillary cancer; pitfalls
references.citation: World J Surg. 2012 Jun;36(6):1262-7
references.pmid: 22270993
references.citation: Br J Surg. 2013 Mar;100(4):497-503
references.pmid: 23254479
references.citation: World J Surg. 2008 May;32(5):716-21
references.pmid: 18087766
references.citation: World J Surg. 2012 Mar;36(3):593-7
references.pmid: 22207493
references.citation: Surgery. 2005 Dec;138(6):1095-100, discussion 1100-1
references.pmid: 16360396
references.citation: Arch Otolaryngol Head Neck Surg. 2007 Oct;133(10):1028-30
references.pmid: 17938327
references.citation: Br J Surg. 2010 Nov;97(11):1687-95
references.pmid: 20730856
references.citation: World J Surg. 2006 May;30(5):833-40
references.pmid: 16555024
references.citation: Otolaryngol Head Neck Surg. 2000 Jan;122(1):31-8
references.pmid: 10629479
references.citation: J Surg Oncol. 2006 Dec 15;94(8):692-700
references.pmid: 17131429
references.citation: World J Surg. 2010 Jun;34(6):1239-46
references.pmid: 20012290
references.citation: World J Surg. 2009 Aug;33(8):1680-3
references.pmid: 19506945