Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results

Abstract Background Mediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment...

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Main Authors: Yuntao Song, Liang Dai, Guohui Xu, Tianxiao Wang, Wenbin Yu, Keneng Chen, Bin Zhang
Format: Article
Language:English
Published: BMC 2021-08-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-021-01326-9
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author Yuntao Song
Liang Dai
Guohui Xu
Tianxiao Wang
Wenbin Yu
Keneng Chen
Bin Zhang
author_facet Yuntao Song
Liang Dai
Guohui Xu
Tianxiao Wang
Wenbin Yu
Keneng Chen
Bin Zhang
author_sort Yuntao Song
collection DOAJ
description Abstract Background Mediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment of thyroid carcinoma with mediastinal lymphadenopathy. Materials and methods We retrospectively reviewed the clinical pathologic data and short-term outcomes of thyroid cancer patients with suspicious MLNM treated with video mediastinoscopy-assisted mediastinal dissection at our institution from 2017 to 2020. Results Nineteen patients were included: 14 with medullary thyroid carcinoma and five with papillary thyroid carcinoma. Superior mediastinal nodes were positive in nine (64.3%) patients with medullary thyroid carcinoma and in four (80.0%) patients with papillary carcinoma. No fatal bleeding occurred. There were three cases of temporary recurrent laryngeal nerve (RLN) palsy postoperatively, one of which was bilateral. Four patients had temporary hypocalcemia requiring supplementation, one had a chyle fistula, and one developed wound infection after the procedure. Postoperative serum molecular markers decreased in all patients. One patient died of cancer while the other 18 patients remained disease-free, with a median follow-up of 33 months. Conclusion Video mediastinoscopy-assisted superior mediastinal dissection can be performed relatively safely in patients with suspicious MLNM. This diagnostic and therapeutic approach may help control locoregional recurrences.
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spelling doaj.art-fa16626b0c8d40e78fe2f7e56455b2842022-12-21T18:58:03ZengBMCBMC Surgery1471-24822021-08-012111710.1186/s12893-021-01326-9Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary resultsYuntao Song0Liang Dai1Guohui Xu2Tianxiao Wang3Wenbin Yu4Keneng Chen5Bin Zhang6Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), First Department of Thoracic Surgery, Peking University Cancer Hospital and InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), First Department of Thoracic Surgery, Peking University Cancer Hospital and InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Head and Neck Surgery, Peking University Cancer Hospital and InstituteAbstract Background Mediastinal lymph node metastases (MLNM) are not rare in thyroid cancer, but their treatment has not been extensively studied. This study aimed to explore the preliminary application of video mediastinoscopy-assisted superior mediastinal dissection in the diagnosis and treatment of thyroid carcinoma with mediastinal lymphadenopathy. Materials and methods We retrospectively reviewed the clinical pathologic data and short-term outcomes of thyroid cancer patients with suspicious MLNM treated with video mediastinoscopy-assisted mediastinal dissection at our institution from 2017 to 2020. Results Nineteen patients were included: 14 with medullary thyroid carcinoma and five with papillary thyroid carcinoma. Superior mediastinal nodes were positive in nine (64.3%) patients with medullary thyroid carcinoma and in four (80.0%) patients with papillary carcinoma. No fatal bleeding occurred. There were three cases of temporary recurrent laryngeal nerve (RLN) palsy postoperatively, one of which was bilateral. Four patients had temporary hypocalcemia requiring supplementation, one had a chyle fistula, and one developed wound infection after the procedure. Postoperative serum molecular markers decreased in all patients. One patient died of cancer while the other 18 patients remained disease-free, with a median follow-up of 33 months. Conclusion Video mediastinoscopy-assisted superior mediastinal dissection can be performed relatively safely in patients with suspicious MLNM. This diagnostic and therapeutic approach may help control locoregional recurrences.https://doi.org/10.1186/s12893-021-01326-9Thyroid carcinomaVideo mediastinoscopyMediastinal lymph node metastasesMediastinal dissectionMediastinal lymphadenopathy
spellingShingle Yuntao Song
Liang Dai
Guohui Xu
Tianxiao Wang
Wenbin Yu
Keneng Chen
Bin Zhang
Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results
BMC Surgery
Thyroid carcinoma
Video mediastinoscopy
Mediastinal lymph node metastases
Mediastinal dissection
Mediastinal lymphadenopathy
title Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results
title_full Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results
title_fullStr Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results
title_full_unstemmed Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results
title_short Video mediastinoscopy-assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy: preliminary results
title_sort video mediastinoscopy assisted superior mediastinal dissection in the treatment of thyroid carcinoma with mediastinal lymphadenopathy preliminary results
topic Thyroid carcinoma
Video mediastinoscopy
Mediastinal lymph node metastases
Mediastinal dissection
Mediastinal lymphadenopathy
url https://doi.org/10.1186/s12893-021-01326-9
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