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What is lymph node dissection

2023-02-28 04:17:19

To clean the lymph nodes, can minimize the recurrence and metastasis of cancer cells.

In the history of thyroid cancer treatment, cervical lymph node dissection is often inseparable from radical cervical lymph node dissection.This procedure involves the removal of the lymphoid tissue in the neck and the surrounding fat, muscles, nerves, blood vessels, etc.Also known as radical neck dissection, total neck dissection, radical cervical lymph node resection, etc.

There are four different methods of cervical lymph node dissection, including radical cervical lymphadenectomy, functional (modified) cervical lymphatic dissection, selective lymphadenectomy, and central lymphadenectomy.At present, central lymph node dissection and functional neck lymph node dissection are more commonly used in surgery.


The cervical lymph nodes are very abundant. The American Joint Committee on Cancer has divided the cervical lymph nodes into seven zones, which is of great significance for clinical diagnosis. The border is basically the vascular sheath of the carotid artery. The medial side of the carotid sheath belongs to the Central District, while the lateral side belongs to the lateral neck region. Lymph node dissection in the Central District is a routine procedure, and even in earlier thyroid cancer, the risk of occult metastasis in the Central District is higher. There are even about 30% to 50% of patients, in the preoperative or intraoperative examination did not find lymph node metastasis, but postoperative pathology found metastasis. Therefore, the domestic opinion tends to recommend ipsilateral prophylactic lymphadenectomy in the Central District, even in the absence of lymph node metastasis on preoperative evaluation. But like follicular carcinoma, because it has very little chance of lymph node metastasis, so can not do routine cleaning.

Lateral neck dissection is not recommended if metastases are not suspected because of the relatively low incidence of metastasis and the relatively large surgical trauma. At present, it is generally accepted that lymph node dissection should be performed only if the preoperative examination is highly suspected or confirmed the presence of lateral cervical lymph node metastasis. Radical neck dissection is very important for the prognosis of thyroid cancer patients. The more radical the dissection, the better the prognosis. This is because lymph node dissection reduces the risk of thyroid cancer recurrence and metastasis and prolongs patient survival. However, non-standard cleaning not only increases the possibility of recurrence, but also brings great difficulty to the second operation and increases the chance of operative complications