邹杰, 王凯, 张波, 胡季洋. 同期双侧颈淋巴清扫术38例分析[J]. 蚌埠医科大学学报, 2011, 36(4): 366-367.
    引用本文: 邹杰, 王凯, 张波, 胡季洋. 同期双侧颈淋巴清扫术38例分析[J]. 蚌埠医科大学学报, 2011, 36(4): 366-367.
    ZOU Jie, WANG Kai, ZHANG Bo, HU Ji-yang. Simultaneous bilateral neck dissection:a report of 38 cases[J]. Journal of Bengbu Medical University, 2011, 36(4): 366-367.
    Citation: ZOU Jie, WANG Kai, ZHANG Bo, HU Ji-yang. Simultaneous bilateral neck dissection:a report of 38 cases[J]. Journal of Bengbu Medical University, 2011, 36(4): 366-367.

    同期双侧颈淋巴清扫术38例分析

    Simultaneous bilateral neck dissection:a report of 38 cases

    • 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。

       

      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.

       

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