Simultaneous bilateral neck dissection:a report of 38 cases

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.