Neck dissection: cause and effect.
OBJECTIVE
This study aimed to evaluate changes in neck dissection procedures over time in a tertiary university hospital to determine their influence on residency training.


METHODS
Neck dissections performed in a recent decade (2003-2012) were retrospectively analysed and compared with those of an earlier decade (1981-1990).


RESULTS
Nowadays, neck dissections are most frequently performed for thyroid (2003-2012 vs 1981-1990: 60.7 per cent vs 25 per cent, p = 0.002) and less often for epithelial malignancies (23.2 per cent vs 53.5 per cent, p = 0.002). Compared with dissections for thyroid spread, more dissections for epithelial malignancies are extensive (epithelial vs thyroid malignancies, 66 per cent vs 4.9 per cent) and more are performed after chemoradiation failures (25.6 per cent vs 0 per cent).


CONCLUSIONS
This study demonstrates changes in neck dissection procedures over time. There is an increasing preference for conservative treatment for epithelial cancers. In addition, there is a large increase in both the diagnosis and surgical treatment of thyroid cancer. This shift may have a great effect on residents' learning curves and on their ability to achieve competency in performing neck dissections.
Department of Otolaryngology - Head and Neck Surgery,Hadassah Medical Centre, Hebrew University of Jerusalem,Israel.
N
N
Hirshoren
Department of Otolaryngology - Head and Neck Surgery,Hadassah Medical Centre, Hebrew University of Jerusalem,Israel.
F
F
Ashqar
Department of Otolaryngology - Head and Neck Surgery,Hadassah Medical Centre, Hebrew University of Jerusalem,Israel.
J M
JM
Weinberger
Department of Otolaryngology - Head and Neck Surgery,Hadassah Medical Centre, Hebrew University of Jerusalem,Israel.
R
R
Eliashar
D002983:Clinical Competence; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000639:trends; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000193:education / Q000706:statistics & numerical data / Q000639:trends*; D009375:Neoplasms, Glandular and Epithelial / Q000601:surgery*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*
Organ Preservation