Evaluation of Total Thyroidectomy with Prophylactic Central Neck Dissection as an Alternative to Total Thyroidectomy Alone in Clinically Node-Negative Papillary Thyroid Carcinoma

Document Type : Original Article

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Department of General Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Abstract

Background: PTC is the most popular form of differentiated thyroid carcinoma. Total thyroidectomy is the preferred
procedure for all PTC. In spite of CND is performed for clinically nodal-positive patients, it still controversial in
cases with clinically negative nodes.
Aim of work: The purpose of this study is to compare the incidence of recurrence and complications of TT only
with TT plus pCND in patients with clinically negative L.N and PTC.
Patients and methods: This retrospective study was conducted in the General Surgery Department at Ain
Shams University Hospitals. The study involved 40 diagnosed cases of PTC with clinically node-negative disease,
all of which were operated on between January 2021 and January 2023.
Results: The incidence of complications was similar in both groups. The rate of temporary recurrent laryngeal
nerve injury was 5% in both groups. The rate of transient hypocalcemia was 5% in the TT only group and 10% in
the TT with pCND group. Additionally, the rate of permanent hypocalcemia was 0% in the TT only group, while it
was 5% in the TT with pCND group. pCND does not significantly reduce the local recurrence risk in cases of PTC.
Conclusion: Total thyroidectomy with pCND in clinically node-negative disease was not associated with increase
in postoperative complications, in spite of having a longer operation time compared to total thyroidectomy without
pCND. However, 40% of cases who performed total thyroidectomy with pCND were found to have lymph node
metastasis.

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