Total thyroidectomy,central neck dissection and radical neck dissection with HARMONIC

abstract

Case report: Fourteen years old male, who was misdiagnosed as Hashimoto thyreoiditis and treated with L-thyroxine for 1.5 years. On clinical examination moderate but constant pain in the neck, symtoms of disphagia and disphonia were present. We found tumor in the left thyroid lobe 2.5 cm and multipl...

e small but firm tumours in the right lobe, with gross lymphadenopathy in central and both lateral neck compartments. Histoathology: Multifocal papillary thyroid carcinoma. Lymph node metastases were found in 44 out of 82 dissected in all dissected neck compartments. Operative time was less than 3 hours. Postoperative treatment consisted of radioiodine ablation with 5.55GBq and L-thyroxine suppression. On regular follow up examination there were no complications regarding recurrent laryngeal nerve palsy or hypoparathyreoidism. Conclusion: Ultrascision technique is safe and applicable device even in radical surgery of thyroid carcinoma. Surgeon must be experienced in thyroid surgery. Combined collar and modified Mc Fee incisions provided sufficient operative approach with excellent cosmetic result. The mean operative time was significantly shorter with excellent haemo and lymphostasis.

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