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Central Neck Dissection for Transoral Endoscopic Thyroidectomy Vestibular Approach

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Transoral Neck Surgery

Abstract

Endoscopic thyroidectomy by vestibular approach is potentially a better technical procedure to anatomize the central compartment lymph nodes, both levels VI and VII. This is especially true for the most caudal portion because of the excellent view and angle, which minimize instrument interference with clavicles and sternum. We provide in this chapter a review and update with a comparative analysis of endoscopic versus robotic transoral thyroidectomy approach for central compartment dissection.

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References

  1. Agrawal N, Evasovich MR, Kandil E, et al. Indications and extent of central neck dissection for papillary thyroid cancer: an American Head and Neck Society Consensus Statement. Head Neck. 2017;37:1267–79.

    Google Scholar 

  2. Carty SE, Cooper DS, Doherty GM, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009;19(11):1153–8.

    PubMed  Google Scholar 

  3. Orloff LA, Kuppersmith RB. American Thyroid Association’s central neck dissection terminology and classification for thyroid cancer consensus statement. Otolaryngol Head Neck Surg. 2010;142(1):4–5.

    PubMed  Google Scholar 

  4. Hartl DM, Travagli JP. Central compartment neck dissection for well-differentiated thyroid cancer: a surgical technique. World J Surg. 2011;35:1553–9.

    PubMed  Google Scholar 

  5. Pai S, Tufano RP. Central compartment lymph node dissection. Oper Tech Otolaryngol. 2009;20:39–43.

    Google Scholar 

  6. Kandil E, Abdelghani S, Friedlander P, et al. Motor and sensory branching of the recurrent laryngeal nerve in thyroid surgery. Surgery. 2011;150(6):1222–7.

    PubMed  Google Scholar 

  7. Armstrong WG, Hinton JW. Multiple divisions of the recurrent laryngeal nerve. An anatomic study. AMA Arch Surg. 1951;62:532–9.

    CAS  PubMed  Google Scholar 

  8. Pereira JA, Jimeno J, Miquel J, et al. Nodal yield, morbidity, and recurrence after central neck dissection for papillary thyroid carcinoma. Surgery. 2005;138:1095–100.

    PubMed  Google Scholar 

  9. Henry JH, Gramatic L, Denizot A, et al. Morbidity of prophylactic lymph node dissection in the central neck area in patients with papillary thyroid carcinoma. Langenbecks Arch Surg. 1998;282:167–9.

    Google Scholar 

  10. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133.

    PubMed  PubMed Central  Google Scholar 

  11. Kouvaraki MA, Lee JE, Shapiro SE, et al. Preventable reoperations for persistent and recurrent papillary thyroid carcinoma. Surgery. 2004;136:1183–91.

    PubMed  Google Scholar 

  12. Hamming JH, Roukema JA. Management of regional lymph nodes in papillary, follicular, and medullary thyroid cancer. In: Textbook of endocrine surgery. Philadelphia: W.B. Saunders; 1997. p. 155–66.

    Google Scholar 

  13. Mizrachi A, Shaha AR. Lymph node dissection for differentiated thyroid cancer. Mol Imaging Radionucl Ther. 2017;26(Supp 1):10–5.

    PubMed  PubMed Central  Google Scholar 

  14. Gambardella C, Tartaglia E, Nunziata A, et al. Clinical significance of prophylactic central compartment neck dissection in the treatment of clinically node-negative papillary thyroid cancer patients. World J Surg Oncol. 2016;14(1):247.

    PubMed  PubMed Central  Google Scholar 

  15. Selberherr A, Riss P, Scheduba C, et al. Prophylactic “first-step” central neck dissection (level 6) does not increase morbidity after (total) thyroidectomy. Ann Surg Oncol. 2016;23(12):4016–22.

    PubMed  PubMed Central  Google Scholar 

  16. McHenry CR, Rosen IB, Walfish PG. Prospective management of nodal metastases in differentiated thyroid cancer. Am J Surg. 1991;20:854.

    Google Scholar 

  17. Grebe SK, Hay ID. Thyroid cancer nodal metastases: biologic significant and therapeutic considerations. Surg Oncol Clin N Am. 1996;5:43–63.

    CAS  PubMed  Google Scholar 

  18. Calo PG, Pisano G, Medas F, et al. Total thyroidectomy without prophylactic central neck dissection in clinically node-negative papillary thyroid cancer: is it adequate treatment? World J Surg Oncol. 2014;12:153.

    Google Scholar 

  19. Truran P, Harrison B. Central neck dissection in the treatment of well-differentiated thyroid cancer. Int J Endocr Oncol. 2015;2(4):291–9.

    Google Scholar 

  20. Wang TS, Cheung K, Farrokhyar F, et al. A meta-analysis of the effect of prophylactic central compartment neck dissection on locoregional recurrence rates in patients with papillary thyroid cancer. Ann Surg Oncol. 2013;20(11):3477–83.

    PubMed  Google Scholar 

  21. Goepfert RP, Clayman GL. Management of the central compartment in differentiated thyroid carcinoma. Eur J Surg Oncol. 2018;44(3):327–31. https://doi.org/10.1016/j.ejso.2019.09.004.

    Article  PubMed  Google Scholar 

  22. Mirallie E, Visset J, Sagan C, et al. Localization of cervical node metastasis of papillary thyroid carcinoma. World J Surg. 1999;23:970–3.

    CAS  PubMed  Google Scholar 

  23. Goropoulos A, Karamoshos K, Chrostodoulou A, et al. Efstratiou I: value of the cervical compartments in the surgical treatment of papillary thyroid carcinoma. World J Surg. 2004;28(12):1275–81.

    PubMed  Google Scholar 

  24. Randolph GW, Duh QY, Heller KS, et al. The prognostic significance of nodal metastases from papillary thyroid carcinoma can be stratified based on the size and number of metastatic lymph nodes, as well as the presence of extranodal extension. Thyroid. 2012;22:1144–52.

    PubMed  Google Scholar 

  25. Sessa L, Lombardi CP, De Crea C, et al. Risk factors for central neck lymph node metastases in micro- versus macro-clinically node negative papillary thyroid carcinoma. World J Surg. 2018;42(3):623–9.

    PubMed  Google Scholar 

  26. Spriano G, Ruscito P, Pellini R, et al. Pattern of regional metastases and prognostic factors in differentiated thyroid carcinoma. Acta Otorhinolaryngol Ital. 2009;29(6):312–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Wells SA, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015;25(6):567–610.

    PubMed  PubMed Central  Google Scholar 

  28. Lin JD, Chao TC. Follicular thyroid carcinoma: from diagnosis to treatment. Endocr J. 2006;53(4):441–8.

    CAS  PubMed  Google Scholar 

  29. Lin JD, Liou MJ, Chao TC, et al. Prognostic variables of papillary and follicular thyroid carcinoma patients with lymph node metastases and without distant metastases. Endocr Relat Cancer. 1999;6(1):109–15.

    CAS  PubMed  Google Scholar 

  30. Coburn MC, Wanebo JH. Prognostic factors and management considerations in patients with cervical metastases of thyroid cancer. Am J Surg. 1992;164(6):671–6.

    CAS  PubMed  Google Scholar 

  31. Guo P, Tang Z, Ding Z, et al. Transoral endoscopic thyroidectomy with central neck dissection: experimental studies on human cadavers. Chin Med J. 2014;127(6):1067–70.

    PubMed  Google Scholar 

  32. Anuwong A, Kim HY, Dionigi G. Transoral endoscopic thyroidectomy using vestibular approach: updates and evidences. Gland Surg. 2017;6:277–84.

    PubMed  PubMed Central  Google Scholar 

  33. Russell JO, Clark J, Noureldine SI, et al. Transoral thyroidectomy and parathyroidectomy – a North American series of robotic and endoscopic transoral approaches to the central neck. Oral Oncol. 2017;71:75–80.

    PubMed  Google Scholar 

  34. Benhidjeb T. Transoral endoscopic thyroidectomy with central neck dissection. Chin Med J. 2015;128(13):1838.

    PubMed  PubMed Central  Google Scholar 

  35. Anuwong A. Transoral endoscopic thyroidectomy vestibular approach: a series of the first 60 human cases. World J Surg. 2016;40:491–7.

    PubMed  Google Scholar 

  36. Razavi CR, Fondong A, Tufano RP, et al. Central neck dissection via the transoral approach. Ann Thyroid. 2017;2(5):pii: 11. https://doi.org/10.21037/aot.2017.10.02.

    Article  Google Scholar 

  37. Dionigi G, Lavazza M, Wu C-W, et al. Transoral thyroidectomy: why is it needed? Gland Surg. 2017;6:272–6.

    PubMed  PubMed Central  Google Scholar 

  38. Razavi CR, Russell JO. Indications and contraindications to transoral thyroidectomy. Ann Thyroid. 2017;2(5):pii: 12.

    Google Scholar 

  39. Kim HY, Chai YJ, Dionigi G, et al. Transoral robotic thyroidectomy: lessons learned from an initial consecutive series of 24 patients. Surg Endosc. 2017;32(2):688–94.

    PubMed  Google Scholar 

  40. Dionigi G, Tufano RP, Russell J, et al. Transoral thyroidectomy: advantages and limitations. J Endocrinol Investig. 2017;40(11):1259–63. https://doi.org/10.1007/s40618-017-0676-0. Epub 2017 Apr 21. PubMed PMID: 28432675.

    CAS  Google Scholar 

  41. Dionigi G, Chai YJ, Tufano RP, et al. Transoral endoscopic thyroidectomy via a vestibular approach: why and how? Endocrine. 2018;59(2):275–9. https://doi.org/10.1007/s12020-017-1451-x. [Epub ahead of print] PubMed PMID: 29039144.

    CAS  PubMed  Google Scholar 

  42. Anuwong A, Ketwong K, Jitpratoom P, et al. Safety and outcomes of the transoral endoscopic thyroidectomy vestibular approach. JAMA Surg. 2018;153(1):21–7.

    PubMed  Google Scholar 

  43. Wang Y, Xie QP, Yu X, et al. Preliminary experience with transoral endoscopic thyroidectomy via vestibular approach: a report of 150 cases in a single center. Zhonghua Wai Ke Za Zhi. 2017;55(8):587–91.

    CAS  PubMed  Google Scholar 

  44. Chai YJ, Chung JK, Anuwong A, et al. Transoral endoscopic thyroidectomy for papillary thyroid microcarcinoma: initial experience of a single surgeon. Ann Surg Treat Res. 2017;93(2):70–5.

    PubMed  PubMed Central  Google Scholar 

  45. Anuwong A, Sasanakietkul T, Jitpratoom P, et al. Transoral endoscopic thyroidectomy vestibular approach (TOETVA): indications, techniques, and results. Surg Endosc. 2018;32(1):456–65.

    PubMed  Google Scholar 

  46. Chai UJ, Kim HY, Kim HK, et al. Comparative analysis of 2 robotic thyroidectomy procedures: transoral versus bilateral axillo-breast approach. Head Neck. 2018;40(5):886–92. https://doi.org/10.1002/hed.25034. [Epub ahead of print] PubMed PMID: 29240281.

    PubMed  Google Scholar 

  47. Dionigi G, Bacuzzi A, Lavazza M, et al. Transoral endoscopic thyroidectomy: preliminary experience in Italy. Updat Surg. 2017;69(2):225–34.

    Google Scholar 

  48. Richmon JD, Kim HY. Transoral robotic thyroidectomy (TORT): procedures and outcomes. Gland Surg. 2017;6(3):285–9.

    PubMed  PubMed Central  Google Scholar 

  49. Stack BC Jr, Ferris RL, Goldenberg D, American Thyroid Association Surgical Affairs Committee, et al. American Thyroid Association consensus review and statement regarding the anatomy, terminology, and rationale for lateral neck dissection in differentiated thyroid cancer. Thyroid. 2012;22(5):501–8.

    PubMed  Google Scholar 

  50. Park JO, Kim CS, Song JN, et al. Transoral endoscopic thyroidectomy via the tri-vestibular routes: results of a preclinical cadaver feasibility study. Eur Arch Otorhinolaryngol. 2014;271(12):3269–75.

    PubMed  Google Scholar 

  51. Lee HY, Richmon JD, Walvekar RR, et al. Robotic transoral periosteal thyroidectomy (TOPOT): experience in two cadavers. J Laparoendosc Adv Surg Tech A. 2015;25(2):139–42.

    PubMed  Google Scholar 

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Correspondence to Gianlorenzo Dionigi .

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Dionigi, G., Kim, H.Y., Vasiliou, E., Tufano, R.P. (2020). Central Neck Dissection for Transoral Endoscopic Thyroidectomy Vestibular Approach. In: Russell, J., Inabnet III, W., Tufano, R. (eds) Transoral Neck Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-30722-6_15

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  • DOI: https://doi.org/10.1007/978-3-030-30722-6_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-30721-9

  • Online ISBN: 978-3-030-30722-6

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