Abstract
BackgroundVarious incisions and approaches have been developed for lateral neck dissection. The purpose of this study was to compare the surgical and cosmetic outcomes of a single low transverse incision with the hockey stick incision for lateral neck dissection (LND) in patients with papillary thyroid carcinoma (PTC).MethodsWe retrospectively analyzed 97 patients with PTC who underwent therapeutic LND and total thyroidectomy by low transverse incision (62 patients) or hockey stick incision (35 patients). We compared the operative results, cosmetic outcomes, objective scar measurement, and sensory disturbance between the two groups.ResultsThe number of harvested and metastatic lymph nodes, Vancouver Scar Scale scores, and sensory change were not significantly different between the two groups. The mean number of harvested lymph nodes in level II was 9.82 vs. 9.63 (P = 0.885) (transverse incision vs. hockey stick incision, respectively) and in level V was 6.36 vs. 5.63 (P = 0.597). However, subjective satisfaction with the scar and neck contour was higher in the low transverse incision group compared with the hockey stick incision group. Scores for scar consciousness and sensory change were not significantly different between the two groups.ConclusionsA single low transverse incision may provide equivalent surgical outcomes and superior cosmetic outcomes compared with the hockey stick incision for LND in PTC.
Highlights
Various incisions and approaches have been developed for lateral neck dissection
papillary thyroid carcinoma (PTC) has a good prognosis, cervical lymph node metastasis is frequently detected, which increases locoregional recurrence and decreases survival, when the metastasis is in the lateral compartment lymph node [2, 3]
Therapeutic lateral neck dissection (LND) should be performed in patients with PTC when lymph node metastasis is in the lateral compartment [4]
Summary
The purpose of this study was to compare the surgical and cosmetic outcomes of a single low transverse incision with the hockey stick incision for lateral neck dissection (LND) in patients with papillary thyroid carcinoma (PTC). Several types of incision can be used for LND of patients with PTC, including a hockey stick incision, an apron incision, a single transverse incision, a modified MacFee incision, or a modified Schobinger incision [6, 7]. A hockey stick incision provides excellent access to neck levels I and II, but invades the relaxed skin-tension line and can result in scar hypertrophy [8]. A single low transverse incision is parallel to, and does not invade, the relaxed skin-tension line, and usually favors a good postoperative scar. Access to the upper neck levels, including levels I and II might be more difficult with low transverse incision than with other
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