Video-assisted selective lateral neck dissection for papillary thyroid carcinoma

Abstract

The minimally invasive video-assisted thyroidectomy (MIVAT) for thyroid benign nodules and central neck dissection (CND) for papillary thyroid microcarcinoma (PTMC) have been applied, presently, we attempted to perform video-assisted selective lateral neck dissection (VASLND) for papillary thyroid carcinoma (PTC). Twenty-six consecutive PTC patients with unilateral tumor (size <4.0 cm) and suspected lymph node metastasis at level III, IV, or IIa were included from March 2009 to January 2012. VASLND was successfully performed in all 26 PTC patients. The mean operative time was 46 min (range 26-75 min) on VASLND. No major complications occurred. Average postoperative hospital stay was 3.6 days (range 2-8 days). The mean number of removed nodes was 7.3 (range 4-12) in central neck and 8.3 (range 3-21) in lateral compartment. Positive yield amounted to a mean value of 2.6 (range 0-5) and 3 (range 0-6), respectively. No persistent or recurrent disease was observed in any patient during a follow-up period. The cosmetic result was excellent. Our initial experience demonstrates that VASLND is feasible and safe for selected PTCs, with superior appearance and less pain. Nevertheless, larger series and comparative studies with longer follow-up could be necessary to confirm its oncological effectiveness.