ABSTRACT

Objectives:

To evaluate the incidence of hypocalcemia and recurrent laryngeal nerve disfunction secondary to level VI lymph node dissection in patients with papillary thyroid carcinoma.

Methods:

This randomized prospective study investigated a group of 60 consecutive papillary thyroid carcinoma patients who initially underwent thyroidectomy plus level VI neck dissection (29 patients) - with or without lateral neck dissection - and thyroidectomy alone (31 patients). In order to evaluate the morbidity of central lymph node dissection, postoperative recurrent nerve dysfunction and hypocalcemia were compared between two groups.

Results:

Early postoperative hypocalcemia was higher in the thyroidectomy plus neck dissection group (group 1) than the thyroidectomy without neck dissection group (group 2) (18/29-62.1% vs. 6/31-19.4%; p=0.001). Permanent hypocalcemia developed in 4 patients of group 1 (4/29-13.8%) and 2 patients of group 2 (2/31-6.5%) six months after surgery (P=0.672). No permanent vocal cord paralysis was observed in both groups. Transient vocal cord paralysis occurred in a patient of group 1.

Conclusions:

According to the study results, central lymph node dissection can be safely applied in papillary thyroid carcinoma patients without increasing the risk of permanent morbidity in the hands of experienced surgeons.