Stručni rad
https://doi.org/10.20471/acc.2020.59.s1.15
Elective Central Compartment Lymph Node Dissection Does not Increase the Risk of Postoperative Hypoparathyroidism in Patients Treated for Differentiated Thyroid Cancer
Boris Stubljar
; Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre Milosrdnice University Hospital Centre
Marija Pastorčić Grgić
; Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre Milosrdnice University Hospital Centre
Ljiljana Mayer
; Laboratory Diagnostics Division, University Hospital for Tumors, Sestre Milosrdnice University Hospital Centre
Pavao Perše
; Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre Milosrdnice University Hospital Centre
Tomislav Tomičević
; Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, Sestre Milosrdnice University Hospital Centre
Sažetak
The aim of this study was to compare the incidence of postoperative hypoparathyroidism
in two groups of patients who were treated for differentiated thyroid cancer. Methods:
A retrospective analysis of 179 patients who were treated for differentiated thyroid cancer in our institution
from January 2011 until December 2018 was performed. Only patients initially treated with
total thyroidectomy and those who did not have preoperatively confirmed central compartment and
lateral neck lymph node metastases were included in this study. Two main groups of patients were
analysed. The patients who were treated with total thyroidectomy and elective central compartment
lymph node dissection simultaneously were included in the first group. The patients who were treated
only with total thyroidectomy were included in the second group. The rate of transitory and persistent
postoperative hypoparathyroidism was compared between the two groups. Results: A total of 117
patients (65.4%) underwent total thyroidectomy and elective central compartment lymph node dissection
simultaneously (TT + CCLN d group). The remaining 62 patients (34.6%) underwent total
thyroidectomy only (TT group). A total of 22.6% patients in the TT group developed postoperative
hypoparathyroidism compared with 25.6% in the TT + CCLN d group. The rate of persistent hypoparathyroidism
in the TT and TT + CCLN d groups was 3.2% and 6.0%, respectively. The difference
in the rate of transient and persistent postoperative hypoparathyroidism was not statistically significant
between the two groups. Within the TT + CCLN d group, 82.9% of patients underwent ipsilateral
paratracheal lymph node dissection and 17.1% underwent bilateral paratracheal lymph node dissection.
The rate of postoperative hypoparathyroidism was analysed in those two subgroups of patients
and did not prove to be statistically significant. Discussion: While its impact on the local recurrence
rate is still controversial, elective central compartment lymph node dissection could be a great tool for
selection of patients who could profit from adjuvant radioiodine treatment. On the other hand, central
compartment lymph node dissection could potentially increase the risk of hypoparathyroidism due to
involuntary injury to parathyroid glands and/or their blood supply. Our study did not find a statistically
significant difference regarding postoperative hypoparathyroidism between patients who underwent
central compartment lymph node dissection compared with patients who underwent total thyroidectomy only. Our data are not in accordance with some of the previously published studies.
Our results demonstrated that elective central compartment lymph node dissection is a safe
procedure and does not significantly increase the risk of postoperative hypoparathyroidism when it is
performed simultaneously with total thyroidectomy.
Ključne riječi
differentiated thyroid cancer; total thyroidectomy; central compartment lymph node dissection; paratracheal dissection; postoperative hypoparathyroidism
Hrčak ID:
248280
URI
Datum izdavanja:
1.11.2020.
Posjeta: 1.701 *