Endoscopic-assisted lateral neck dissection and open lateral neck dissection in the treatment of lateral neck lymph node metastasis in papillary thyroid carcinoma: A comparison of therapeutic effect

Tao Ma; Shuai Zhang; Dongmei Huang; Gang Zhang; Boyi Chen; Ning Zhang

doi:10.12669/pjms.38.7.5826

Endoscopic-assisted lateral neck dissection and open lateral neck dissection in the treatment of lateral neck lymph node metastasis in papillary thyroid carcinoma: A comparison of therapeutic effect

Pak J Med Sci. 2022 Sep-Oct;38(7):1905-1910. doi: 10.12669/pjms.38.7.5826.

Authors

Tao Ma¹, Shuai Zhang², Dongmei Huang³, Gang Zhang⁴, Boyi Chen⁵, Ning Zhang⁶

Affiliations

¹ Tao Ma, Department of General Surgery, Baoding No.1 Central Hospital, Baoding, 071000, Hebei, China.
² Shuai Zhang, Department of General Surgery, Baoding No.1 Central Hospital, Baoding, 071000, Hebei, China.
³ Dongmei Huang, Department of Thyroid and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
⁴ Gang Zhang, Department of General Surgery, Baoding No.1 Central Hospital, Baoding, 071000, Hebei, China.
⁵ Boyi Chen, Department of General Surgery, Baoding No.1 Central Hospital, Baoding, 071000, Hebei, China.
⁶ Ning Zhang, Department of General Surgery, Baoding No.1 Central Hospital, Baoding, 071000, Hebei, China.

Abstract

Objectives: To compare the therapeutic effect of endoscopic-assisted lateral neck dissection and open lateral neck dissection in the treatment of lateral neck lymph node metastasis of patients with papillary thyroid carcinoma (PTC).

Methods: A retrospective analysis was carried out focusing on the general clinical data of 86 patients with PTC treated Baoding No.1 Central Hospital from January 2020 to September 2021. According to different surgical methods, enrolled patients were divided into the endoscopic surgery group (n = 34) and the open surgery group (n = 52). Further comparison was performed on the operation indexes [operation time, postoperative length of stay in hospital, number of dissected lymph nodes (central area, lateral cervical area), number of metastatic lymph nodes (central area, lateral cervical area), hospitalization cost], postoperative complications, postoperative neck pain, neck numbness discomfort score, and satisfaction with postoperative cosmetic effect.

Results: The operation time and hospitalization cost of the endoscopic surgery group were higher than those of the open surgery group, and the intraoperative blood loss was lower than that of the open surgery group, with statistically significant differences (p<0.05). There was no significant difference in the length of stay in the hospital, the number of dissected lymph nodes, the number of metastatic lymph nodes and the detection rate of lymph nodes in zone II between the two groups (p>0.05). Furthermore, a statistically significant difference was observed in the incidence of postoperative complications between the two groups, which was lower in the endoscopic surgery group (29.4%) than that in the open surgery group (51.9%) (p<0.05). There was no significant difference in postoperative neck pain scores between the two groups (p>0.05). While the postoperative neck numbness discomfort score, and satisfaction score with postoperative cosmetic effect in the endoscopic surgery group were better than those in the open surgery group, and the difference was statistically significant (p<0.05).

Conclusion: Endoscopic-assisted lateral neck dissection can reduce intraoperative blood loss and postoperative complication incidence in the treatment of lateral neck lymph node metastasis of PTC. However, it has the disadvantages of longer operation time and high hospitalization costs.

Keywords: Endoscopic-assisted; Lymph node metastasis; Open lateral neck dissection; Papillary thyroid carcinoma.