This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Outcomes for patients with papillary thyroid cancer who do not undergo prophylactic central neck dissection. BJS 2016; 103: 218-225.

Published: 29th October 2015

Authors: I. J. Nixon, L. Y. Wang, I. Ganly, S. G. Patel, L. G. Morris, J. C. Migliacci et al.

Background

The role of prophylactic central neck dissection (CND) in the management of papillary thyroid cancer (PTC) is controversial. This report describes outcomes of an observational approach in patients without clinical evidence of nodal disease in PTC.

Method

All patients who had surgery between 1986 and 2010 without CND for PTC were identified. All patients had careful clinical assessment of the central neck during preoperative and perioperative evaluation, with any suspicious nodal tissue excised for analysis. The cohort included patients in whom lymph nodes had been removed, but no patient had undergone a formal neck dissection. Recurrence‐free survival (RFS), central neck RFS and disease‐specific survival (DSS) were calculated using the Kaplan–Meier method.

Results

Of 1798 patients, 397 (22·1 per cent) were men, 1088 (60·5 per cent) were aged 45 years or more, and 539 (30·0 per cent) had pT3 or pT4 disease. Some 742 patients (41·3 per cent) received adjuvant treatment with radioactive iodine. At a median follow‐up of 46 months the 5‐year DSS rate was 100 per cent. Five‐year RFS and central neck RFS rates were 96·6 and 99·1 per cent respectively.

Conclusion

Observation of the central neck is safe and should be recommended for all patients with PTC considered before and during surgery to be free of central neck metastasis.

Full text

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Leading article

Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.

Authors: J. H. H. Olsen, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg

Original article

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.

Authors: N. Patel, R. J. Egan, B. R. Carter, D. M. Scott‐Coombes, M. J. Stechman, A. Afzaal et al.

Outcomes for patients with papillary thyroid cancer who do not undergo prophylactic central neck dissection. BJS 2016; 103: 218-225.

Background

Method

Results

Conclusion

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A good surgical death. BJS 2019; 106: 1427-1428.

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Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia.

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Human model of burn injury that quantifies the benefit of cooling as a first aid measure. BJS 2019; 106: 1472-1479.

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry. BJS 2019; 106: 1495-1503.