Column 9. Lobectomy and Paratracheal Node Dissection

It is debatable whether contralateral paratracheal nodes should be dissected when lobectomy is performed for papillary carcinoma. “General Rules for the Description of Thyroid Cancer” published by the Japanese Society of Thyroid Surgery states that dissection of contralateral paratracheal node is not necessary. Since an improvement in prognosis can be expected following therapeutic node dissection, one opinion is that it is better to perform bilateral paratracheal dissection even in lobectomy, while it has been demonstrated that the incidence of re-operation complications in terms of recurrence to the paratracheal nodes increases. Meanwhile, there is another opinion that the contralateral paratracheal node should not be dissected for lobectomy, to avoid adhesion extending to the opposite side in the event that completion total thyroidectomy is needed.