Patterns, Outcomes And Associated Factors Of Neck Dissection For Thyroid Malignancy Patients At Two Selected Tertiary Hospitals In Ethiopia, A 5 Years Study.

Patterns, Outcomes And Associated Factors Of Neck Dissection For Thyroid Malignancy Patients At Two Selected Tertiary Hospitals In Ethiopia, A 5 Years Study.

Helina Amare Abebe
St.Paul medical college, Ethiopia /Addis Ababa, Ethiopia

Introduction: Neck dissection plays a crucial role in treating differentiated thyroid carcinoma, enhancing disease-free survival when nodal metastasis is present. This study aims to evaluate neck dissection practices in low socioeconomic country, potentially improving patient management for thyroid malignancy.
Objective: To assess patterns, outcomes, and associated factors of neck dissection for thyroid malignancy patients at two selected tertiary hospitals from May 2019- June 2024.
Methods: A 5-year analytical cross-sectional study was carried out through a review of documented records of patients undergoing neck dissection for thyroid malignancy, through a structured checklist at Saint Paul Hospital Millennium Medical College and Tibebe Ghion Specialized Hospital. The data was cleaned and analyzed using SPSS version 27 for Windows. Binary logistic regression was used to check the association between the dependent and independent variables with P- Value < 0.05.
Result: Lateral neck dissection was the predominant surgical approach in 51 (57.3%), with therapeutic indications in 79 (88.8%) cases. Common complications included hypocalcemia 10 (11.2%), unilateral recurrent laryngeal nerve injury 5 (5.6%) and seroma 9 (10.1%). Patients who have undergone combined lateral and central neck dissection have increased odds of developing hypocalcemia (AOR = 6.111, P = 0.010). Additionally, papillary thyroid carcinoma has reduced odds of developing recurrent laryngeal nerve injury with an odds ratio of 0.062 (AOR = 0.062, 95% CI = 0.007–0.560, P = 0.013) compared to other histologic types. Previous thyroidectomy history also increased the odds of developing seroma by 4.913 times (AOR = 4.913, 95% CI = 1.105–21.831, P = 0.036. The mean Lymph node yield after surgery was 11.48.
Conclusion: Neck dissection for thyroid malignancy, as practiced in the study, partially aligns with existing recommendations such as the American Thyroid Association Guidelines. The most common complications include hypocalcemia, recurrent laryngeal nerve injury, and seroma, which remain significant concerns. Careful surgical planning and meticulous management are important to minimize these risks effectively.

Keywords: Neck Dissection, Thyroid malignancy, Lymph node yield.