Comparison of Conventional and Video-Assisted Lateral Neck Lymphadenectomy for Thyroid Cancer

Abstract

The thoroughness and safety of removal of lymph nodes by endoscopic thyroidectomy is questioned. We applied video-assisted lateral neck lymphadenectomy and evaluated its feasibility and safety. Sixty-six patients with papillary thyroid carcinoma (PTC) and lateral neck lymph node metastasis (TNM staging: cN1b) who agreed to surgical therapies were retrospectively compared. The patients were divided into two groups: a conventional lateral neck lymphadenectomy group (CL group) and a minimally invasive video-assisted lateral neck lymphadenectomy group (VALNL group). Several parameters, including operative time, length of incision, operative hemorrhage, postoperative drainage, postoperative complications, and length and costs of hospitalization were compared. No significant differences were found in age, sex, blood loss, postoperative drainage, postoperative complications, number of lymph nodes resected, or length and costs of hospitalization (all P > 0.05), but the surgery time was longer for the VALNL group than for the CL group (P < 0.01). Fewer patients had local skin paresthesia in the VALNL group (P < 0.01), and the incision length was shorter in the VALNL group than in the CL group (P < 0.01). Video-assisted lateral neck lymphadenectomy for metastatic PTC is feasible and safe, and it has similar short-term outcomes and similar costs when compared with traditional open surgery.