Analysis of Surgical Outcomes in Endoscopic-Assisted Lateral Neck Dissection

Laryngoscope. 2024 May;134(5):2221-2227. doi: 10.1002/lary.31143. Epub 2023 Nov 8.

Abstract

Background: Currently, endoscopic-assisted lateral neck dissection (EALND) is performed to reduce postoperative scarring of the anterior neck. This study aimed to compare surgical outcomes between EALND and conventional open lateral neck dissection (COLND) for papillary thyroid carcinoma (PTC) with lateral lymph node metastases (LNM).

Methods: The study reviewed 103 PTC patients who were classified on the basis of surgical type and statistically compared using propensity score matching analysis.

Results: The mean operation time is longer, and the cost of surgery is higher in the EALND group than COLND group (all p < 0.05). The numbers of retrieved and positive level II LNs, the rate of level II LNs detection between two groups do not differ significantly (all p > 0.05). The incidence of postoperative neck numbness is lower, and patients are more satisfied with postoperative neck scarring in the EALND group than COLND group (all p < 0.05). The common complications of two groups are transient recurrent laryngeal nerve injury and transient hypoparathyroidism.

Conclusions: EALND is safe and feasible compared with COLND. The incision is more aesthetically satisfactory, which makes EALND a surgical approach for PTC patients with lateral LNM.

Level of evidence: 3 Laryngoscope, 134:2221-2227, 2024.

Keywords: conventional open lateral neck dissection; cosmetic benefit; endoscopic‐assisted lateral neck dissection; papillary thyroid carcinoma; propensity score matching analysis.

MeSH terms

  • Carcinoma, Papillary* / surgery
  • Cicatrix / pathology
  • Humans
  • Lymphatic Metastasis
  • Neck Dissection
  • Retrospective Studies
  • Thyroid Cancer, Papillary / surgery
  • Thyroid Neoplasms* / pathology
  • Thyroid Neoplasms* / surgery
  • Thyroidectomy
  • Treatment Outcome