The advantages of extended subplatysmal dissection in thyroid surgery-the "mobile window" technique

Langenbecks Arch Surg. 2017 Mar;402(2):257-263. doi: 10.1007/s00423-016-1545-6. Epub 2017 Jan 3.


Purpose: Minimal access thyroidectomy, using various techniques, is widely known, but respective data on thyroidectomy for thyroid cancer with lymphadenectomy is scarce. The present study aims to evaluate the feasability of extended subplatysmal dissection in combination with a small incision ("mobile window" technique).

Methods: A retrospective study was performed analysing data from 93 patients. All patients suffered from thyroid carcinoma and underwent (total) thyroidectomy, bilateral cervico-central (levels VI and VII) and functional lateral neck dissection (levels II to V) on the side of the malignancy. In group A, consisting of 47 patients, the operation was performed by a traditional Kocher incision (minimal range 6-7 cm), in 46 patients (group B) a mini-incision (≤4 cm) was made. Intra- and postoperative morbidity as well as oncological accuracy were assessed.

Results: There was no significant difference between the two groups comparing postoperative pathological diagnosis, intra- and postoperative complications and the number of removed lymph nodes. However, operating time was slightly longer in group A and thyroid weight was heavier in group B.

Conclusions: Extended subplatymsal dissection allows thyroidectomy and even lateral lymphadenectomy for thyroid carcinoma via "mobile" mini-incision. The procedure is safe, of equivalent oncological accuracy compared to traditional incision and the cosmetic results are excellent.

Keywords: Cervical lymphadenectomy; Functional neck dissection; Mini-incision; Thyroid cancer; Thyroid carcinoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Dissection / methods
  • Feasibility Studies
  • Female
  • Humans
  • Lymph Node Excision / methods*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neck Dissection / methods*
  • Operative Time
  • Retrospective Studies
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / methods*
  • Young Adult