Comparative Study of Performing Versus Sparing of Level VB Neck Dissection in Low-risk Papillary thyroid carcinoma patients with lateral neck metastasis to levels II, III, and IV

Hammad, Ahmed Mohammed Abdel-Bar; Farahat, Mahmoud Saad; Elzohery, Yasmine Hany Abdel Moamen; Raslan, Ibrahim Khalid

doi:10.21608/ejsur.2024.336461.1278

Comparative Study of Performing Versus Sparing of Level VB Neck Dissection in Low-risk Papillary thyroid carcinoma patients with lateral neck metastasis to levels II, III, and IV

Document Type : Original Article

Authors

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

10.21608/ejsur.2024.336461.1278

Abstract

Background: Papillary thyroid carcinoma (PTC) is the most prevalent malignant thyroid neoplasm with a favorable
prognosis. It tends to metastasize via the lymphatic system, which is an important risk factor for locoregional recurrence
and disease-free survival. The standard treatment for affected lateral cervical lymph nodes is therapeutic lateral neck
dissection; however, the accurate definition of the extent of dissection is widely debated.
Aim: To compare between levels II–III–IV–VB and levels II–III–IV modified radical neck dissection in low-risk PTC
patients (<45 years old, T1, T2, M0) with lymph node metastasis in groups II–IV and absent level V lymph node metastasis
as regards locoregional recurrence and postoperative complications including shoulder dysfunction, supraclavicular
numbness, and neuropathic pain.
Patients and Methods: A total of 40 individuals were enrolled in this randomized, comparative, prospective clinical trial,
divided into two groups, 20 patients each. We performed level VB dissection in group A in addition to levels II, III, and
IV, while we preserved level VB in group B. Patients were followed up every 3 months for a year postoperatively to record
postoperative complications and locoregional recurrence.
Results: Receiver Although there was a higher incidence of locoregional recurrence in group B, the difference was
statistically nonsignificant. The incidence of shoulder dysfunction was higher in group A, but the difference was
statistically nonsignificant. There were no significant variations between both groups as regards supraclavicular numbness
and neuropathic pain.
Conclusion: Sparing level VB in lateral neck dissection in low-risk PTC increased the rate of locoregional recurrence
though statistically nonsignificant; however, it reduced the incidence of postoperative shoulder dysfunction as compared
with level VB dissection.

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