Neck Dissection for Thyroid Cancer

Abstract

Neck dissection removes potential or proven metastases to cervical lymph nodes from well-differentiated thyroid carcinomas. This can potentially improve rates of overall survival for patients. Lymph node metastases of thyroid carcinomas can be diagnosed by clinical examination, preoperative imaging, or during surgical exploration. The indication and degree of dissection are important classifications in a neck dissection. In dealing with thyroid cancer, the surgeon must be aware that nodal clearance should be comprehensive, systematic, and compartment oriented. The surgical care of the patient begins with preoperative evaluation and optimizing the patient undergoing anesthesia and surgery. This chapter outlines the important steps in executing a neck dissection. It highlights the principles of the procedure and the causes of technical obstacles and difficulties during a lymph node dissection. Indications, preoperative preparation, pitfalls, operative strategy and technique, postoperative care, and complications are discussed.