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C H A P T E R 2 | Oncologic Components of Lymphadenectomy

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advocate for more selective use of RAI therapy according to disease biology, it is pos- sible that the information gleaned from pCCND will help modulate the use of RAI therapy in the future. CONCLUSION A CCND increases exposure of the RLN and the risk of devascularization of the parathyroid glands, but pCCND has not been associated with increased risk of RLN injury or permanent hypoparathyroidism in specialized centers. To date, total thyroid- ectomy with pCCND appears to be associated with an overall slightly lower, but not significantly different, locoregional recurrence rate when compared with total thy- roidectomy alone. It is reasonable to offer pCCND if a surgeon’s complication rates are low with this procedure and the information gleaned from knowing the status of the regional central lymph nodes will change the postoperative management of PTC patient. SECTION I: THYROID REFERENCES: 1. Delbridge L, Reeve TS, Khadra M, et al. Total thyroidectomy: the technique of capsular dissection. Aust N Z J Surg 1992;62:96–99. 2. Beenken S, Roye D, Weiss H, et al. Extent of surgery for intermediate-risk well-differentiated thyroid cancer. Am J Surg 2000;179:51–56. 3. Gauger PG, Delbridge LW, Thompson NW, et al. Incidence and importance of the tubercle of Zuckerkandl in thyroid surgery. Eur J Surg 2001;167:249–254. 4. Antakia R, Edafe O, Uttley L, et al. Effectiveness of preventative and other surgical measures on hypocalcemia following bilateral thyroid surgery: a systematic review and meta-analysis. Thyroid 2015;25:95–106. 5. Gourgiotis S, Moustafellos P, Dimopoulos N, et al. Inadvertent parathyroidectomy during thyroid surgery: the incidence of a complication of thyroidectomy. Langenbecks Arch Surg 2006;391:557–560. 6. Prazenica P, O’Keeffe L, Holy R. Dissection and identification of parathyroid glands during thyroidectomy: association with hypocalcemia. Head Neck 2015;37:393–399. 7. Puzziello A, Rosato L, Innaro N, et al. Hypocalcemia following thyroid surgery: incidence and risk factors. A longitudinal multicenter study comprising 2,631 patients. Endocrine 2014;47:537– 542. 8. Thomusch O, Machens A, Sekulla C, et al. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery 2003;133:180–185. 9. Edafe O, Antakia R, Laskar N, et al. Systematic review and meta-analysis of predictors of post- thyroidectomy hypocalcaemia. Br J Surg 2014;101:307–320. 10. Shaha AR, Burnett C, Jaffe BM. Parathyroid autotransplantation during thyroid surgery. J Surg Oncol 1991;46:21–24. 11. Cayo AK, Yen TW, Misustin SM, et al. Predicting the need for calcium and calcitriol supplementation after total thyroidectomy: results of a prospective, randomized study. Surgery 2012;152:1059–1067. 12. Raffaelli M, De Crea C, Sessa L, et al. Prospective evaluation of total thyroidectomy versus ipsilateral versus bilateral central neck dissection in patients with clinically node-negative papil- lary thyroid carcinoma. Surgery 2012;152:957–964. 13. Grodski S, Stalberg P, Robinson BG, et al. Surgery versus radioiodine therapy as definitive management for graves’ disease: the role of patient preference. Thyroid 2007;17:157–60. 14. Misiolek M, Waler J, Namyslowski G, et al. Recurrent laryngeal nerve palsy after thyroid cancer surgery: a laryngological and surgical problem. Eur Arch Otorhinolaryngol 2001;258:460–462.