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Bilateral and Ipsilateral Central Neck Dissection in Total Thyroidectomy: a Long Term Comparison of Complications

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Abstract

The role of prophylactic central compartment neck dissection (CCND) in total thyroidectomy (TT) is controversial in patients without clinically evident lymph nodes metastasis (cN0) because of association with transient and permanent hypoparathyroidism (HPT) as well as transient and permanent recurrent laryngeal nerve (RLN) injury. Instead of bilateral central neck dissection (bCCND), ipsilateral central compartment neck dissection (iCCND) has recently been proposed as a safer, alternative treatment for selected patients. The aim of this study is to characterize the morbidity that CCND (ipsilateral and bilateral) adds to TT. We enrolled 453 patients: Group A (316 patients) underwent TT alone, Group B (86 patients) underwent TT + iCCND, Group C (51 patients) underwent TT + bCCND. We compared the rates of RLN injury and HPT in three groups and data analysis showed that iCCND was associated with increased rate of transient HPT but not permanent HPT and bCCND was associated with increased rate of transient and permanent HPT, when compared with TT alone. Further studies are needed to evaluate the clear advantages of CCND (both ipsilateral and bilateral), but this should be considered in the context of an higher risk of surgical complications (especially transient and permanent hypoparathyroidism), in comparison with TT alone.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Cervico-facial Surgery, Ospedale San Camillo de Lellis, via John Fitzgerald Kennedy, 02100, Rieti, Italy

    Davide Rosati & Paolo Ruscito

  2. Department of Surgery “P. Valdoni”, Sapienza” University of Rome, Azienda Policlinico Umberto I, Rome, Italy

    Marco Bononi

  3. Department of Otorhinolaryngology and Cervico-facial Surgery, Ospedale San Giovanni Calibita - Fatebenefratelli, Isola Tiberina, Rome, Italy

    Marco Radici

  4. Department of Sensory Organs, Sapienza” University of Rome, Azienda Policlinico Umberto I, Rome, Italy

    Carlo Cavaliere & Antonio Minni

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  1. Davide Rosati
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  3. Paolo Ruscito
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Correspondence to Davide Rosati.

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Rosati, D., Bononi, M., Ruscito, P. et al. Bilateral and Ipsilateral Central Neck Dissection in Total Thyroidectomy: a Long Term Comparison of Complications. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 6206–6212 (2022). https://doi.org/10.1007/s12070-021-02904-2

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