Impact of Prophylactic Bilateral Central Lymph Nodes Dissection in Patients with Papillary Thyroid Carcinoma; Short Term Outcome

Main Article Content

Mohammed Farid Elhelbawy
Ahmed Elgendy
Abd El-Wahhab Hemedah Gad
Ahmed Attia Darwish

Abstract

Background: Papillary thyroid carcinoma is the most common thyroid carcinoma. There is a debate on prophylactic removal of central lymph nodes. Some authors advise it to avoid recurrence while other investigators condemn it due to its higher risk of recurrent laryngeal nerve injury and/or hypoparathyroidism.

Aim of the Work: The aim of this study was to evaluate the safety and morbidity of central lymph nodes dissection during total thyroidectomy in the management of patients with papillary thyroid carcinoma.

Patients and Methods: Twelve patients were confirmed by histopathological evaluation to have papillary thyroid examination. Total thyroidectomy was done through transverse neck incision followed by removal of bilateral central group of lymph nodes. Patients were examined postoperatively for recurrent laryngeal nerve injury or hypoparathyroidism. Follow up was done 6 months later with neck ultrasonography, thyroglobulin and antithyroglobulin antibodies.

Results: Thirty four percent of the studied cases proved to have lymph nodes metastasis. temporary hypocalcemia occurred in only one patient in this study and was temporary. Recurrent laryngeal nerve affection happened in 17% of the studied cases and was reversible by medical treatment. No evidence of recurrence happened in the first 6 months after operation.

Conclusion: The risk of postoperative recurrent laryngeal nerve injury or hypoparathyroidism is minimal after prophylactic CLND. Postoperative hypocalcemia and recurrent laryngeal nerve injury are usually reversible.

Keywords:
Central lymph nodes, hypocalcemia, recurrent laryngeal nerve, papillary thyroid carcinoma.

Article Details

How to Cite
Elhelbawy, M. F., Elgendy, A., Gad, A. E.-W. H., & Darwish, A. A. (2020). Impact of Prophylactic Bilateral Central Lymph Nodes Dissection in Patients with Papillary Thyroid Carcinoma; Short Term Outcome. Journal of Advances in Medicine and Medical Research, 32(16), 18-25. https://doi.org/10.9734/jammr/2020/v32i1630625
Section
Original Research Article

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