Objective: Traditional open surgery for lateral neck dissection for patients with papillary thyroid carcinoma (PTC) leaves an unsightly scar. It is necessary to apply small incision to complete lateral neck dissection with endoscopy-technique for PTC and to evaluate its feasibility and safety.
Methods: Between March 2010 and May 2011, 6 cases of PTC with no definite lymph node metastasis at level II-IV and 12 cases of PTC at T1-T4 with definite lymph node metastasis at level II-V received minimally invasive endoscopy-assisted lateral neck dissection. After accomplishing thyroidectomy and central compartment dissection, ipsilateral level II-IV,VI orII-VI dissection via small neck incision was performed.
Results: This procedure was carried out successfully in all 18 patients. The incision was 5 cm every patient. Postoperative pT1 was 5 cases, pT2 5 cases, pT3 6 cases, pT4 2 cases, pN0 5 cases, N1b 13 cases. Mean operative time for lateral neck dissection was 3.6 hours (ranging 2.5-5.0 hours). No significant blood loss or complications occurred. Thirteen patients showed lymph node metastases in both central or lateral neck. The mean number of harvested nodes was 33.1 (ranging 16-61). No residual or recurrent disease was found in 2-3 years follow-up time.
Conclusion: Minimally invasive video-assisted comprehensive neck dissection for metastatic papillary thyroid carcinoma is feasible and safe with excellent cosmetic results.