THE ROLE OR LYMPH-NODAL DISSECTION IN THE TREATMENT OF DIFFERENTIATEDTHYROID CANCERS

Total thyroidectomy seems to be the surgical procedure of choice for m ost surgeons in the treatment of differentiated thyroid cancer. The in itial surgical procedure for thyroid disease started at the beginning of the XIXth century (Porta, Blizzard) on the basis of experiences of veterinary surgery. After that, at the end of the XIXth (Kocher) and a t the beginning of the XXth century, Lahey and Plummer started to perf orm ever more radical dissection on the thyroid.If total thyroidectomy is to be universally accepted as the best procedure in treatment of d ifferentiated thyroidal cancer, the role of lymphnodal dissection rema ins controversial for the prevention as well as for the treatment of l ocal and distant metastases, and for the prognosis. The first descript ions of cervical lymphnodal dissection technique have been made by Sir G.W. Crile (7). The lymphnodes involved have been reported to be remo ved in the drainage of the thyroid: from the initial radical dissectio n, to the simple Node Picking, and then the Functional Neck Dissection , defined by Suarez (4) and Bocca(2) as Conservative Neck Dissection, or Modified Neck Dissection type 3 (Medina) (1).