Minimally invasive video-assisted lateral neck lymphadenectomy for the papillary thyroid carcinoma with cervical lymph nodes metastasis

Abstract

Objective: Minimally invasive video-assisted technique has been successfully used in thyroidectomy to treat low-and intermediate-risk papillary thyroid cancer. But there was very little experience of this technique to be used in the lateral neck lymphadenectomy to treat papillary thyroid cancer with lateral neck lymph node metastasis. This study aimed to verify the potential benefits of a new minimally invasive video-assisted lateral neck lymphadenectomy that evaluated the likelihood of the surgical method as an alternative for thyroid carcinoma with lateral lymph node metastasis. Method: A total of 58 patients were retrospectively compared, which included two groups: Following thyroidectomy and the central neck node dissection (level VI), the first group underwent the conventional lateral neck lymphadenectomy and the other group underwent video-assisted lateral neck lymphadenectomy. In addition to the comparison of treatment outcomes between the new treatment and the conventional one, other parameters including operative time, length of incision, operative hemorrhage, postoperative drainage, length and costs of hospitalization were also compared. Results: Patients who received the new surgical method had significantly shorter incisional length, lower incidence of local skin paresthesia and shorter length of hospitalization when compared to the conventional treatment. Conclusions: Compared with the conventional lateral neck lymphadenectomy for cN1b-stage papillary thyroid carcinoma, the new minimally invasive video-assisted lateral neck lymphadenectomy is a feasible and safe alternative for treatment of thyroid carcinoma with cervical lymph node metastases since it has the advantages of less postoperative complications and better cosmetic outcome.

Identification of Long Non-Coding RNA Expression Profiles and Co-Expression Genes in Thyroid Carcinoma Based on The Cancer Genome Atlas (TCGA) Database

“…Since lymph nodes metastasis is a critical predictive factor in thyroid carcinoma [21,22], we further analyzed the relationship between differentially expressed lncRNAs and lymph nodes 9754 metastasis. Among 352 differentially expressed lncRNAs, we found that 4 upregulated genes (LINC01016, LHX1-DT, IGF2-AS, and MIR1-1HG-AS1) were significantly expressed across patients with N1 than N0 (Table 4), and the results were visualized by heatmap ( Figure 7).…”

A scoping review of endoscopic and robotic techniques for lateral neck dissection in thyroid cancer

“…Among studies with at least 12 months of follow-up, there were no reported recurrences, sTg levels were low or undetectable, and there were no differences in postoperative complications between groups, including transient hypocalcemia or hoarseness, Horner's, seroma, hematoma, wound infections, or chyle leak (32)(33)(34)(35)(36). There were no cases of permanent RLN injury or hypocalcemia in the studies.…”

“…Among studies, the mean LN yield was 25-41, except in two studies that had a much lower yield of 8.3 (range 3-21) and 8.5 (range 8-9) (30)(31)(32)(33)(34)(35)(36)(37)(38). Mean operative time for VASLND alone was 46-60 minutes, but when included with thyroidectomy and CND, mean operative times were 198-220 minutes (30)(31)(32)(33)(34)37).…”

“…All patients in the VASLND groups were satisfied with their cosmetic results (32,34,35). In a study by Zhang et al, the cosmetic outcomes were evaluated by a numerical and verbal response scales, evaluated in both the VASLND group (n=54) and transcervical group (n=38) at 1 year after surgery.…”

“…In Miccoli et al, a modified technique was performed, with thyroidectomy done through a smaller 1.5cm incision above the sternal notch and the VASLND performed via a lateral video-assisted approach requiring a second 5-7mm incision along the posterior border of the SCM ( Figure 1B ) ( 31 ). In Li et al, their LND is performed by placing 5mm trocar just superior to the clavicular head to accommodate blunt dissecting forceps while the laparoscope and other working instruments are placed through the 4-5cm anterior neck incision ( 34 ). After the working space is created, an additional 2mm retractor is then placed through the lateral neck skin ipsilateral to the LND to retract the jugular vein ( 34 ).…”