Investigation of selective neck dissection for differentiated thyroid cancer / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the indication, operative method and results of selective neck dissection (SND) for differentiated thyroid cancer.</p><p><b>METHODS</b>According to the level system and the operative guideline of the American Head and Neck Society, 40 cases of thyroid cancer (phase I 35 cases, phase II 2 cases, phase III 3 cases) were collected prospectively. Thyroidectomy plus SND was performed on all the cases. And the indication, operative methods and results were investigated.</p><p><b>RESULTS</b>Nine of the 40 cases received level VI dissection only. Twenty-four of the 40 cases received SND with levels </= 3 by a simple transverse incision on the neck. The overall lymph nodes positive rate was 67% (28/42). The positive rates of VI, IV, III, II and V levels were 58% (23/40), 48% (16/33), 48% (14/29), 50% (7/14) and 27% (4/15) respectively. The positive rate of level VI was not significantly higher than those of the level IV, III and II (P > 0.05). One parathyroid was found in 20% (8/40) of the specimen and 27% (11/40) of the patients had transient hypocalcemia, but no permanent hypocalcemia. Three (7.5%) of the patients had vocal cord paralysis for a short period of time and no permanent case was detected. Nineteen patients were followed up for more than 6 months after the operation and no enlarged neck lymph node was found by ultrasound at the 6th month postoperatively.</p><p><b>CONCLUSION</b>It is reasonable to give SND to the early thyroid cancer patients.</p>