Papillary thyroid carcinoma has a high prevalence of lymphatic metastases, especially in the central compartment (20-50%, according to different studies). There is controversy about routinely performing prophylactic lymphadenectomy; detractors argue that it increases morbidity (recurrent laryngeal nerve injury and hypoparathyroidism), which would not affect the prognosis of these patients. Advocates emphasize that it improves patient staging and reduces the recurrence rate.

We present a retrospective and descriptive observational study of patients who underwent surgery for papillary thyroid carcinoma with prophylactic lymphadenectomy of the central compartment from 2008-2022, performed by specialized endocrine surgeons. Postoperative complications and oncological results have been analyzed. All the patients had postoperative laryngoscope.

228 patients met the inclusion criteria. The rate of temporary palsy has been 4.9% and permanent 0.33%. The rate of temporary hypoparathyroidism has been 38.3% and permanent 5.8%. 29% present metastasis in the central compartment. 25.4% in the anatomopathological results present aggressive histological variants and/or T3 with invasion of the capsule. The recurrence rate was 0.48%, but none in the central compartment.

Prophylactic lymphadenectomy can be a safe technique and can reduce the recurrence rate in the central compartment. In our case, the staging of the patients improves because 29% present metastasis in the central compartment and 25.4% would be undertreated without prophylactic lymphadenectomy due to aggressive histology or presenting capsular invasion.