Video-Assisted Lateral Neck Dissection Has Good Efficacy and Safety: A Long-Term Follow-Up Study.

OBJECTIVE

To systematically evaluate the efficacy and safety of video-assisted lateral neck dissection (VALND) in the treatment of lateral lymph node metastasis (LLNM) of papillary thyroid carcinoma (PTC).

METHODS

A retrospective cohort study was performed on PTC patients with LLNM who underwent VALND in our center from June 2013 to December 2017. The safety of VALND was evaluated by the rate of postoperative complications, while its efficacy was evaluated by the number of lateral necks dissected (LND) and the rate of recurrence.

RESULTS

A total of 191 patients with pathologically confirmed PTC and LLNM who underwent VALND were included in this study. The median follow-up time was 69.21 (95% CI: 65.83-72.58) months and the mean follow-up time was 64.36 months. There were 3 patients with accessory nerve injury, 1 with hypoglossal nerve injury, 1 with vagus nerve injury, 1 with phrenic nerve injury and 2 with lymphatic fistula. The number of LND during VALND in the left and right lateral neck compartment was 45.27 ± 13.92 and 43.33 ± 13.99, respectively. 2 patients developed pathologically confirmed recurrences that required reoperation, with recurrent lesions located in Level II and Level V, respectively.

CONCLUSIONS

Our findings demonstrate that VALND has excellent safety and commendable efficacy in the treatment of LLNM of PTC. Compared with conventional open surgery, VALND performs better in reducing incision length and enhancing cosmetic satisfaction. VALND warrants global promotion in view of the benefits it can bring to PTC patients.