Division of Endocrine Surgery, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam Road, Hong Kong.
J Oncol. 2011;2011:127929. doi: 10.1155/2011/127929. Epub 2011 Sep 29.
Prophylactic central neck dissection (pCND) in differentiated thyroid carcinoma (DTC) is one of the most controversial surgical subjects in recent times. To date, there is little evidence to support the practice of pCND in patients with DTC undergoing total thyroidectomy. Although the recently revised American Thyroid Association (ATA) guideline has clarified many inconsistencies regarding pCND and has recommended pCND in "high-risk" patients, many issues and controversies surrounding the subject of pCND in DTC remain. The recent literature has revealed an insignificant trend toward lower recurrence rate in patients with DTC who undergo total thyroidectomy and pCND than those who undergo total thyroidectomy alone. However, this was subjected to biases, and there are concerns whether pCND should be performed by all surgeons who manage DTC because of increased surgical morbodity. Performing a unilateral pCND may be better than a bilateral pCND given its lower surgical morbidity. Further studies in this controversial subject are much needed.
预防性中央颈部清扫术（pCND）在分化型甲状腺癌（DTC）中的应用是近年来最具争议的外科手术之一。迄今为止，几乎没有证据支持对接受全甲状腺切除术的 DTC 患者进行 pCND。尽管最近修订的美国甲状腺协会（ATA）指南澄清了关于 pCND 的许多不一致之处，并建议对“高危”患者进行 pCND，但围绕 DTC 中 pCND 主题仍存在许多问题和争议。最近的文献显示，与仅接受全甲状腺切除术的患者相比，接受全甲状腺切除术和 pCND 的 DTC 患者的复发率有轻微下降的趋势。然而，这受到了偏见的影响，人们担心是否所有治疗 DTC 的外科医生都应该进行 pCND，因为它会增加手术的发病率。单侧 pCND 的手术发病率低于双侧 pCND，因此单侧 pCND 可能更好。在这个有争议的课题中，还需要进行更多的研究。
