Journal of Yeungnam Medical Science

Original article

The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma: Jin Gu Kang, Young Ah Kim, Jung Eun Choi, Soo Jung Lee, Su Hwan Kang; Yeungnam Univ J Med. 2020;37(3):202-209. Published online April 10, 2020; DOI: https://doi.org/10.12701/yujm.2020.00031

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Background
Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC.
Methods
We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed.
Results
CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different.
Conclusion
Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

Citations

Citations to this article as recorded by

Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis
Yujie Li, Lingling Lao
Brazilian Journal of Otorhinolaryngology.2023; 89(6): 101318. CrossRef
Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
Ying-Jun Wu, Jian-Biao Wang, Fei-Bo Li, Lei Jin, Liang Zhou, Lei Xie, Claudio Casella
International Journal of Endocrinology.2022; 2022: 1. CrossRef

Case Report

A Case of Idiopathic Hypoparathyroidism with Extensive Intracranial Calcification.: Wook Nyeon Kim, Jung Sang Hah; Yeungnam Univ J Med. 1997;14(1):220-226. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.220

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Abstract PDF: Idiopathic hypoparathyroidism is frequeutly associated with intracranial calcification and neuropsychiatric abnormalities. The most commonly recognized central nervous system manifestations of chronic hypoparathyroidism are seizure, alteration of mental function and extrapyramidal signs. We present a care of hypoparathyroidism, demonstrating extensive intracranial calcification, not only basal ganglia, but also outside the extrapyramidal system. An 58-year-old woman presented with 30 year history of seizure and memory disturbance. The physical examination and several laboratory studies disclosed normal. However hypocalcemia, hyperphosphatemia with hypocalciuria and decreased parathormone level were demonstrated. Clinical symptoms and signs showed improvement after supplementary calcium and Vit D3 therapy.

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