Safety and feasibility of elective minimally invasive video-assisted central neck dissection for thyroid carcinoma.

Background: Minimally invasive video-assisted thyroidectomy (MIVAT) is accepted as treatment for select patients with thyroid carcinoma. We report both benefits and limitations of elective central neck dissection performed with the MIVAT technique.

Methods: Patients undergoing elective central neck dissection with MIVAT during November 2006 to October 2009 were studied retrospectively. Outcomes included complications and recurrence rates.

Results: In all, 28 patients were studied. There were no recurrences, with median follow-up of 14 months. Eleven patients (39%) had positive central lymph nodes for metastases. No permanent hypocalcemia resulted, although 3 patients (10.7%) experienced transient hypocalcemia on postoperative day 1 (Ca <8 mg/dL). No permanent hypoparathyroidism resulted, although 7 patients (25%) had transient hypoparathyroidism (postanesthesia care unit parathyroid hormone [PTH] <8 mg/dL) treated with short-term supplementation. Transient recurrent laryngeal nerve paresis occurred in 1 patient (3.6%). At the most recent check, 91% of patients had low/undetectable (<1 ng/mL) thyroglobulin.

Conclusions: Elective central neck dissection performed with MIVAT is a safe and feasible procedure in our institutional experience.