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Recently, Shen et al1 analyzed the complication rates of 295 patients after central lymph node dissection (CLND) for papillary thyroid cancer. Without adjusting for imbalances between the groups, the authors concluded that reoperative CLND caused no more complications than initial CLND.
In this series, the risk of neck injury was stacked against initial CLND: 307 (71 unilateral and 118 bilateral initial CLND) vs 136 (76 unilateral and 30 bilateral reoperative CLND) dissected neck sides.1
Machens A, Dralle H. Failure to Consider the Number of Dissected Sides Can Bias Complication Rate Calculations of Central Lymph Node Dissection for Thyroid Cancer. Arch Surg. 2010;145(10):1026-1027. doi:10.1001/archsurg.2010.202