同期双侧颈淋巴清扫术38例分析

邹杰; 王凯; 张波; 胡季洋

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同期双侧颈淋巴清扫术38例分析

邹杰 , 王凯 , 张波 , 胡季洋

文章导航 > 蚌埠医学院学报 > 2011, 36 > 4: (366-367)

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同期双侧颈淋巴清扫术38例分析

1. 蚌埠医学院第二附属医院肿瘤外科, 安徽蚌埠 233040;
2. 蚌埠医学院第一附属医院肿瘤康复中心, 安徽蚌埠 233004

作者简介: 邹杰(1965一),男,副主任医师.

中图分类号: R654

Simultaneous bilateral neck dissection:a report of 38 cases

1. Department of Oncological Surgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040;
2. Oncology Rehabilitation Centre, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R654

摘要: 目的: 探讨同期双侧颈淋巴清扫术的手术方法、适应证及围手术期处理。方法: 38例行同期双侧颈淋巴清扫术患者,其中37例采用双侧功能性颈淋巴清扫或分区性颈淋巴清扫,仅1例行一侧根治性颈淋巴清扫,另一侧行功能性颈淋巴清扫。结果: 全组无一例手术死亡。术后创口出血1例,出现一侧乳糜瘘2例,经负压吸引保守治疗痊愈。1例双甲癌术后第3天气管切开,拔管出院后半年出现呼吸困难,行气管切开后永久带管。咽瘘2例,1例保守治疗痊愈,1例行带蒂胸大肌皮瓣修复痊愈。淋巴结阳性数0~12个。双侧颈淋巴结均阳性21例;一侧淋巴结阳性11例,另一侧阴性;两侧淋巴结阴性6例。结论: 严格掌握手术适应证,术前做好充分准备,围手术期处理及时正确,同期双侧颈淋巴清扫术是安全的,消除了患者二期手术的痛苦,节省了医疗经费。
- 颈淋巴结清扫术 /
- 同期 /
- 双侧
Abstract: Objective: To explore the surgical approach,indications and perioperative management of simultaneous bilateral neck dissection.Methods: Among 38 patients with simultaneous bilateral neck dissection,37 cases were treated by simultaneous bilateral neck dissection or selective neck dissection,only 1 by unilateral radical neck dissection and contralateral functional neck dissection.Results: There was no operative death in this group.Postoperative complications included:1 wound bleeding;2 unilateral chylous fistulas which were recovery by way of expectant treatment with vacuum suction;1 experienced tracheotomy on 3rd day after the operation of bilateral thyroid cancer,on half a year after the tube removed and left hospital who experienced tracheotomy because of difficulty breathing and permanent reserved the tube;2 experienced pharyngeal fistula,among of 2,1 was recovery after expectant treatment and 1 recovery after reconstructed with pedicle pectoralis major myocutaneous flap.The lymph node positive number is from 0 to 12,average 4/cases;21 cases bilateral neck lymph node were positive,11 unilateral lymph node positive and contralateral negative,6 bilateral lymph node negative.Conclusions: If the operation indication is restrictedly controlled,adequate perioperative preparation and timely,correct perioperative management.Simultaneous bilateral neck dissection is safe,eliminating pain of two-stage operation,retrenching payment for medical care.
- lymph node dissection /
- simultaneous /
- bilateral neck

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同期双侧颈淋巴清扫术38例分析

作者简介: 邹杰(1965一),男,副主任医师.

1. 蚌埠医学院第二附属医院肿瘤外科, 安徽蚌埠 233040;
2. 蚌埠医学院第一附属医院肿瘤康复中心, 安徽蚌埠 233004

收稿日期: 2010-10-19

关键词:

摘要: 目的: 探讨同期双侧颈淋巴清扫术的手术方法、适应证及围手术期处理。方法: 38例行同期双侧颈淋巴清扫术患者,其中37例采用双侧功能性颈淋巴清扫或分区性颈淋巴清扫,仅1例行一侧根治性颈淋巴清扫,另一侧行功能性颈淋巴清扫。结果: 全组无一例手术死亡。术后创口出血1例,出现一侧乳糜瘘2例,经负压吸引保守治疗痊愈。1例双甲癌术后第3天气管切开,拔管出院后半年出现呼吸困难,行气管切开后永久带管。咽瘘2例,1例保守治疗痊愈,1例行带蒂胸大肌皮瓣修复痊愈。淋巴结阳性数0~12个。双侧颈淋巴结均阳性21例;一侧淋巴结阳性11例,另一侧阴性;两侧淋巴结阴性6例。结论: 严格掌握手术适应证,术前做好充分准备,围手术期处理及时正确,同期双侧颈淋巴清扫术是安全的,消除了患者二期手术的痛苦,节省了医疗经费。

English Abstract

Simultaneous bilateral neck dissection:a report of 38 cases

1. Department of Oncological Surgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040;
2. Oncology Rehabilitation Centre, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China

Received Date: 2010-10-19

Abstract: Objective: To explore the surgical approach,indications and perioperative management of simultaneous bilateral neck dissection.Methods: Among 38 patients with simultaneous bilateral neck dissection,37 cases were treated by simultaneous bilateral neck dissection or selective neck dissection,only 1 by unilateral radical neck dissection and contralateral functional neck dissection.Results: There was no operative death in this group.Postoperative complications included:1 wound bleeding;2 unilateral chylous fistulas which were recovery by way of expectant treatment with vacuum suction;1 experienced tracheotomy on 3rd day after the operation of bilateral thyroid cancer,on half a year after the tube removed and left hospital who experienced tracheotomy because of difficulty breathing and permanent reserved the tube;2 experienced pharyngeal fistula,among of 2,1 was recovery after expectant treatment and 1 recovery after reconstructed with pedicle pectoralis major myocutaneous flap.The lymph node positive number is from 0 to 12,average 4/cases;21 cases bilateral neck lymph node were positive,11 unilateral lymph node positive and contralateral negative,6 bilateral lymph node negative.Conclusions: If the operation indication is restrictedly controlled,adequate perioperative preparation and timely,correct perioperative management.Simultaneous bilateral neck dissection is safe,eliminating pain of two-stage operation,retrenching payment for medical care.