Comparative Study of Performing Versus Sparing of Level VB Neck Dissection in Low-risk Papillary thyroid carcinoma patients with lateral neck metastasis to levels II, III, and IV | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 44, Issue 2, April 2025, Page 793-798 PDF (589.49 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2024.336461.1278 | ||||
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| Authors | ||||
Ahmed Mohammed Abdel-Bar Hammad  ; Mahmoud Saad Farahat; Yasmine Hany Abdel Moamen Elzohery; Ibrahim Khalid Raslan
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| Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Papillary thyroid carcinoma (PTC) is the most prevalent malignant thyroid neoplasm with a favorable prognosis. It tends to metastasize via the lymphatic system, which is an important risk factor for locoregional recurrence and disease-free survival. The standard treatment for affected lateral cervical lymph nodes is therapeutic lateral neck dissection; however, the accurate definition of the extent of dissection is widely debated. Aim: To compare between levels II–III–IV–VB and levels II–III–IV modified radical neck dissection in low-risk PTC patients (<45 years old, T1, T2, M0) with lymph node metastasis in groups II–IV and absent level V lymph node metastasis as regards locoregional recurrence and postoperative complications including shoulder dysfunction, supraclavicular numbness, and neuropathic pain. Patients and Methods: A total of 40 individuals were enrolled in this randomized, comparative, prospective clinical trial, divided into two groups, 20 patients each. We performed level VB dissection in group A in addition to levels II, III, and IV, while we preserved level VB in group B. Patients were followed up every 3 months for a year postoperatively to record postoperative complications and locoregional recurrence. Results: Receiver Although there was a higher incidence of locoregional recurrence in group B, the difference was statistically nonsignificant. The incidence of shoulder dysfunction was higher in group A, but the difference was statistically nonsignificant. There were no significant variations between both groups as regards supraclavicular numbness and neuropathic pain. Conclusion: Sparing level VB in lateral neck dissection in low-risk PTC increased the rate of locoregional recurrence though statistically nonsignificant; however, it reduced the incidence of postoperative shoulder dysfunction as compared with level VB dissection. | ||||
| Keywords | ||||
| Lateral neck dissection; Level VB dissection; Modified radical neck dissection; Papillary thyroid carcinoma; Selective lateral neck dissection | ||||
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