Endoscopy-assisted lateral neck dissection outperforms conventional open procedures

For the treatment of thyroid cancer with lymph node metastasis, endoscopic-assisted lateral neck dissection (EALND) appears to be a safe and feasible alternative to conventional open lateral neck dissection (COLND), resulting in quicker postoperative recovery, a recent study has found.

Drawing from the online databases of PubMed, Embase, the Cochrane Library, CNKI, Wanfang, and VIP, researchers conducted a meta-analysis of seven studies, one of which was a randomized controlled trial. Overall, 372 patients were included in the quantitative synthesis.

Pooled analysis showed that while the EALND procedure took significantly longer than COLND (mean difference [MD], 24.86, 95 percent confidence interval [CI], 21.75–27.96; p<0.05), healing after surgery was quicker, leading to a significantly shorter postoperative stay (MD, –1.45, 95 percent CI, –2.70 to –0.21; p=0.02).

EALND also led to a more aesthetically pleasing scar, which was significantly shorter than in COLND (MD, –8.14, 95 percent CI, –8.41 to –7.88; p<0.00001).

Similarly, neck discomfort was significantly less likely to occur after EALND vs COLND (odd ratio, 0.19, 95 percent CI, 0.07–0.58; p=0.003).

In contrast, postoperative incidences of transient hypocalcaemia, transient hoarseness, chylous fistula, and choking on water did not differ between groups. The number of lymph nodes retrieved was also comparable between the two surgical approaches.

“Although the operation time was longer, the incision was aesthetically pleasing and the postoperative recovery was fast, making EALND worthy of clinical application,” the researchers said.