Background@#Prophylactic central
neck dissection (CND) in clinically node-negative (cN0)
papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total
thyroidectomy for cN0 unilateral PTC. @*
Methods @#We retrospectively enrolled 174
patients who underwent total
thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND
patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The
incidence of central
lymph node metastasis (CLNM) and
postoperative complications , such as
hypoparathyroidism ,
recurrent laryngeal nerve injury , and
recurrence were assessed. @*Results@#CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The
incidence of postoperative severe
hypocalcemia less than 7.0 was also significantly different (six
patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent
hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the
incidence of
transient hypoparathyroidism ,
recurrence , and
recurrent laryngeal nerve injury was not significantly different. @*Conclusion@#Prophylactic ipsilateral CND has advantage not only to reduce
incidence of some
complications but also to have
similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected
patients undergoing total
thyroidectomy for cN0 unilateral PTC.