Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary?
Papillary thyroid carcinoma (PTC) has a high propensity for regional metastases, however, the impact of such metastases on the outcome of the patients is minimal. The central compartment of the neck is considered the first and the most common echelon of metastases from thyroid carcinoma. Physical ex...
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| Format: | Article |
| Language: | English |
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Wiley
2020-09-01
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| Series: | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2095881120300962 |
| _version_ | 1811327858603196416 |
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| author | Avi Khafif Liron Malka Yosef |
| author_facet | Avi Khafif Liron Malka Yosef |
| author_sort | Avi Khafif |
| collection | DOAJ |
| description | Papillary thyroid carcinoma (PTC) has a high propensity for regional metastases, however, the impact of such metastases on the outcome of the patients is minimal. The central compartment of the neck is considered the first and the most common echelon of metastases from thyroid carcinoma. Physical examination along with ultrasonography are the gold standard pre-operative evaluation of patients with PTC. Ultrasonography is highly sensitive in evaluating lateral neck nodes, however, its value in evaluating the central compartment is limited, resulting in a relatively high rate of occult metastases in this compartment. The main potential complications of para-tracheal neck dissection (PTND) are recurrent laryngeal nerve paralysis and hypocalcemia and these may be higher in patients undergoing PTND compared to thyroidectomy alone. New histological data is available showing no evidence of lymph nodes in the central compartment above a level parallel to the inferior border of the cricoid cartilage. These findings support withholding dissection of the upper para-tracheal region routinely as a part of PTND in patients with well-differentiated thyroid cancer. By doing that, the complications may be lower and identical to thyroidectomy alone, thus may abolish arguments against more common use of elective PTND in patients with thyroid carcinoma. |
| first_indexed | 2024-04-13T15:15:17Z |
| format | Article |
| id | doaj.art-1e95ed526704485ca88e023eb1b6f569 |
| institution | Directory Open Access Journal |
| issn | 2095-8811 |
| language | English |
| last_indexed | 2024-04-13T15:15:17Z |
| publishDate | 2020-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | World Journal of Otorhinolaryngology-Head and Neck Surgery |
| spelling | doaj.art-1e95ed526704485ca88e023eb1b6f5692022-12-22T02:41:52ZengWileyWorld Journal of Otorhinolaryngology-Head and Neck Surgery2095-88112020-09-0163171175Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary?Avi Khafif0Liron Malka Yosef1The Head and Neck Surgery and Oncology Unit, A.R.M Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Affiliated with Ben Gurion University of the Negev, Tel Aviv, IsraelThe Head and Neck Surgery and Oncology Unit, A.R.M Center for Otolaryngology Head and Neck Surgery, Assuta Medical Center, Affiliated with Ben Gurion University of the Negev, Tel Aviv, Israel; Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Affiliated with the Hebrew University of Jerusalem, Rehovot, Israel; Corresponding author. Department of Otolaryngology Head and Neck Surgery, Kaplan Medical Center, POB 1 Rehovot 76100, Israel.Papillary thyroid carcinoma (PTC) has a high propensity for regional metastases, however, the impact of such metastases on the outcome of the patients is minimal. The central compartment of the neck is considered the first and the most common echelon of metastases from thyroid carcinoma. Physical examination along with ultrasonography are the gold standard pre-operative evaluation of patients with PTC. Ultrasonography is highly sensitive in evaluating lateral neck nodes, however, its value in evaluating the central compartment is limited, resulting in a relatively high rate of occult metastases in this compartment. The main potential complications of para-tracheal neck dissection (PTND) are recurrent laryngeal nerve paralysis and hypocalcemia and these may be higher in patients undergoing PTND compared to thyroidectomy alone. New histological data is available showing no evidence of lymph nodes in the central compartment above a level parallel to the inferior border of the cricoid cartilage. These findings support withholding dissection of the upper para-tracheal region routinely as a part of PTND in patients with well-differentiated thyroid cancer. By doing that, the complications may be lower and identical to thyroidectomy alone, thus may abolish arguments against more common use of elective PTND in patients with thyroid carcinoma.http://www.sciencedirect.com/science/article/pii/S2095881120300962Level ⅥParatracheal neck dissectionUpper limit of paratracheal neck dissection |
| spellingShingle | Avi Khafif Liron Malka Yosef Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary? World Journal of Otorhinolaryngology-Head and Neck Surgery Level Ⅵ Paratracheal neck dissection Upper limit of paratracheal neck dissection |
| title | Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary? |
| title_full | Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary? |
| title_fullStr | Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary? |
| title_full_unstemmed | Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary? |
| title_short | Para-tracheal neck dissection – is dissection of the upper part of level Ⅵ necessary? |
| title_sort | para tracheal neck dissection is dissection of the upper part of level vi necessary |
| topic | Level Ⅵ Paratracheal neck dissection Upper limit of paratracheal neck dissection |
| url | http://www.sciencedirect.com/science/article/pii/S2095881120300962 |
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