Comparative Study of Performing Versus Sparing of Level VB Neck Dissection in Low-risk Papillary thyroid carcinoma patients with lateral neck metastasis to levels II, III, and IV

Background: Papillary thyroid carcinoma (PTC) is the most prevalent malignant thyroid neoplasm with a favorableprognosis. It tends to metastasize via the lymphatic system, which is an important risk factor for locoregional recurrenceand disease-free survival. The standard treatment for affected lateral cervical lymph nodes is therapeutic lateral neckdissection; however, the accurate definition of the extent of dissection is widely debated.Aim: To compare between levels II–III–IV–VB and levels II–III–IV modified radical neck dissection in low-risk PTCpatients (<45 years old, T1, T2, M0) with lymph node metastasis in groups II–IV and absent level V lymph node metastasisas regards locoregional recurrence and postoperative complications including shoulder dysfunction, supraclavicularnumbness, and neuropathic pain.Patients and Methods: A total of 40 individuals were enrolled in this randomized, comparative, prospective clinical trial,divided into two groups, 20 patients each. We performed level VB dissection in group A in addition to levels II, III, andIV, while we preserved level VB in group B. Patients were followed up every 3 months for a year postoperatively to recordpostoperative complications and locoregional recurrence.Results: Receiver Although there was a higher incidence of locoregional recurrence in group B, the difference wasstatistically nonsignificant. The incidence of shoulder dysfunction was higher in group A, but the difference wasstatistically nonsignificant. There were no significant variations between both groups as regards supraclavicular numbnessand neuropathic pain.Conclusion: Sparing level VB in lateral neck dissection in low-risk PTC increased the rate of locoregional recurrencethough statistically nonsignificant; however, it reduced the incidence of postoperative shoulder dysfunction as comparedwith level VB dissection.