title: Elective central node dissection: Comparison of open to minimally invasive video-assisted approach.
abstract: Compare outcomes of concomitant primary thyroidectomy with elective central neck dissection (CND) by the standard open versus minimally invasive video-assisted (MIVA) approach.
  
  
  
  Case series chart review, single institution, tertiary referral center.
  
  
  
  Current Procedural Terminology code 60252 was used to identify patients undergoing CND from February 2005 through June 2012. Therapeutic CND and revision cases were excluded. The MIVA approach was performed in patients with low-risk thyroid carcinoma (cT1 or 2, cN0). Primary outcomes included nodal yield and complications, and secondary outcomes included recurrence.
  
  
  
  Of 87 eligible patients, 38 were open and 49 were MIVA. The MIVA group was more likely female (88% vs. 68%, P = .03), but groups were similar in age (46.0 vs. 48.6 mean years, P = .37) and percentage of unilateral dissection (69.4% vs. 71.0%, P = .86). The MIVA group was more often pT1 or 2 (86.9% vs. 76.4%, P = .02). Pathological node positivity was 40% overall and not significantly different between groups (43.5% vs. 35.3%, P = .46). Nodal yield was similar between groups (6.4 vs. 6.8, P = .73). Transient recurrent laryngeal nerve paralysis rates were similar (4.1% vs. 2.6%, P = .71). Transient hypoparathyroidism (postanesthesia care unit parathyroid hormone ≤15 pg/mL) was lower in the MIVA group but not statistically significant (29.2% vs. 45.2%, P = .15). No patients experienced permanent hypoparathyroidism or developed clinically detectable structural recurrence. Rates of biochemical response were similar (any thyroglobulin >1 ng/dL) (13.8% vs. 8.0%, P = .86).
  
  
  
  Concomitant MIVA thyroidectomy with elective CND appears to be a safe and effective alternative to the open approach for low-risk thyroid carcinoma with similar nodal yield, complications, and recurrence.
  
  
  
  4 Laryngoscope, 126:1715-1718, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Hensler
authors.affiliation: Division of Endocrinology, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Falciglia
authors.affiliation: Division of Endocrinology, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Abid
authors.initials: A
authors.lastname: Yaqub
authors.affiliation: Department of Pathology, University of Cincinnati, Cincinnati, Ohio, U.S.A.
authors.forename: Huaitao
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio.
authors.forename: David L
authors.initials: DL
authors.lastname: Steward
mesh_terms: D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D037981:Neck Dissection; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D020535:Video-Assisted Surgery
keywords: Thyroid; central neck; lymph nodes; neck dissection; papillary thyroid cancer; thyroid cancer