Abstract
Our standard surgical approach to patients with papillary thyroid cancer is subtotal thyroidectomy with modified radical neck dissection (MRND) on the affected side. MRND preserves the jugular vein, the sternocleidomastoid muscle, and the accessory nerve, effectively conserving function and cosmesis. Knowledge of the anatomy of the neck, precise staging, prognostic evaluation, and experience are needed for a surgeon to perform MRND. Radical neck dissection should not be performed unless the tumor invades the jugular vein and sternocleidomastoid muscle. Berry picking is not indicated for patients with thyroid cancer. The skin incision used is an extended collar incision. If lymph node metastasis is present at the upper bifurcation of the carotid artery, a modified MacFee incision is used. Taping of the carotid artery or sternocleidomastoid muscle is avoided unless the tumor invades these tissues. MRND is a safe procedure when performed by skilled, experienced surgeons.
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References
EL Mazzaferri RL Young (1981) ArticleTitlePapillary thyroid carcinoma: a 10 year follow-up report of the impact of therapy in 576 patients Am. J. Med. 70 511–518 Occurrence Handle10.1016/0002-9343(81)90573-8 Occurrence Handle1:STN:280:Bi6C2MjivFw%3D Occurrence Handle7211893
LJ DeGroot EL Kaplan M McCormick et al. (1990) ArticleTitleNatural history, treatment, and course of papillary thyroid carcinoma J. Clin. Endocrinol. Metab. 71 414–424 Occurrence Handle1:STN:280:By%2BA3sfjtFc%3D Occurrence Handle2380337
JN Attie (1988) ArticleTitleModified neck dissection in treatment of thyroid cancer: a safe procedure Eur. J. Cancer Clin. Oncol. 24 315–324 Occurrence Handle10.1016/0277-5379(88)90274-X Occurrence Handle1:STN:280:BieC1crktVQ%3D Occurrence Handle3281847
JF Hamming CJ Velde Particlevan de BM Goslings et al. (1989) ArticleTitlePeroperative diagnosis and treatment of metastases to the regional lymph nodes in papillary carcinoma of the thyroid gland Surg. Gynecol. Obstet. 169 107–114 Occurrence Handle1:STN:280:BiaA3s3mtFQ%3D Occurrence Handle2667172
SK Grebe ID Hay (1996) ArticleTitleThyroid cancer nodal metastases: biologic significance and therapeutic considerations Surg. Oncol. Clin. N. Am. 5 43–63 Occurrence Handle1:STN:280:BymA1c7kvVQ%3D Occurrence Handle8789493
S Noguchi A Noguchi N Murakami (1970) ArticleTitlePapillary carcinoma of the thyroid. II. Value of prophylactic lymph node excision Cancer 26 1061–1064 Occurrence Handle1:STN:280:CS6D38npslU%3D Occurrence Handle5476787
S Noguchi N Murakami (1987) ArticleTitleThe value of lymph-node dissection in patients with differentiated thyroid cancer Surg. Clin. North Am. 67 251–261 Occurrence Handle1:STN:280:BiiC2sflvFQ%3D Occurrence Handle3551147
D Simon PE Goretzki J Witte et al. (1996) ArticleTitleIncidence of regional recurrence guiding radicality in differentiated thyroid carcinoma World J. Surg. 20 860–866 Occurrence Handle10.1007/s002689900131 Occurrence Handle1:STN:280:BymH38jitlE%3D Occurrence Handle8678963
S Noguchi N Murakami H Yamashita et al. (1998) ArticleTitlePapillary thyroid carcinoma: modified radical neck dissection improves prognosis Arch. Surg. 133 276–280 Occurrence Handle10.1001/archsurg.133.3.276 Occurrence Handle1:STN:280:DyaK1c7ns12iuw%3D%3D Occurrence Handle9517740
PJ Kennedy AG Poole (1989) ArticleTitleExcision of the submandibular gland: minimizing the risk of nerve damage Aust. N. Z. J. Surg. 59 411–414 Occurrence Handle1:STN:280:BiaB2szgt1c%3D Occurrence Handle2730460
A Miyauchi K Matsusaka M Kihara et al. (1998) ArticleTitleThe role of ansa-to-recurrent-laryngeal nerve anastomosis in operations for thyroid cancer Eur. J. Surg. 164 927–933 Occurrence Handle10.1080/110241598750005093 Occurrence Handle1:STN:280:DyaK1M7ltFyntA%3D%3D Occurrence Handle10029388
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Uchino, S., Noguchi, S., Yamashita, H. et al. Modified Radical Neck Dissection for Differentiated Thyroid Cancer: Operative Technique. World J. Surg. 28, 1199–1203 (2004). https://doi.org/10.1007/s00268-004-7604-0
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DOI: https://doi.org/10.1007/s00268-004-7604-0