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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >What is the appropriate extent of lateral neck dissection in the treatment of metastatic well-differentiated thyroid carcinoma?
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What is the appropriate extent of lateral neck dissection in the treatment of metastatic well-differentiated thyroid carcinoma?

机译：在转移性高分化甲状腺癌的治疗中，将颈椎侧位清扫术的合适程度是多少？

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The evidence presented was obtained from five evidence-based medicine level 4 studies. Although cervical metastases occur in a significant number of cases, the extent of therapeutic neck dissection in the setting of metastatic WDTC remains unclear. Recently published American Thyroid Association (ATA) guidelines recommend dissecting both the central and lateral lymph node compartments in the presence of clinically or histologically apparent lateral cervical metastases. Even though these guidelines explicitly define the central compartment dissection as the removal of level VI, the levels to be addressed in the lateral neck are not clearly stated.1 Modified radical neck dissection and selective neck dissection, including levels II-A, III, and IV, have been advocated, but no official management guidelines exist. At the root of this controversy is the question of whether or not to routinely dissect levels II-B and V, considering the potential morbidity due to injury to the spinal accessory nerve while dissecting these nodal basins.
机译：提出的证据来自五项循证医学第4级研究。尽管在许多情况下会发生宫颈转移，但在转移性WDTC的情况下治疗性颈部清扫术的程度仍不清楚。最近出版的美国甲状腺协会（ATA）指南建议在存在临床或组织学上明显的外侧颈转移瘤的情况下解剖中央和外侧淋巴结腔室。即使这些指南明确将中隔室剥离定义为VI级切除，也未明确指出要在外侧颈中处理的水平。1改良的根治性颈部剥离和选择性颈部剥离，包括II-A，III和第四，已经提倡，但是没有正式的管理指南。争议的根源在于是否要常规解剖II-B和V级水平，考虑到在解剖这些淋巴结时会因脊髓副神经的损伤而导致的潜在发病率。

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