Arslan Necmi, Dursun Engin, Oğuz Berna, Oğuz Haldun, Safak Mustafa Asim, Demirci Münir, Cetin Onur
Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2008 Nov-Dec;18(6):355-61.
Internal jugular vein (IJV) thrombosis is a rare complication of functional and selective neck dissections. It increases morbidity and may seldom be fatal. We investigated the frequency of IJV thrombosis and its relationship with the dissection technique.
We evaluated 52 functional and selective neck dissections performed in 34 male patients (mean age 57 years; range 34 to 76 years) with head and neck cancer. Dissections were mainly performed by sharp dissection (n=27) or cautery (n=25). The patients were examined by Doppler ultrasonography with respect to IJV flow and thrombosis preoperatively, and at two weeks and at 3 to 6 months postoperatively.
In the early postoperative period, thrombosis was observed in 7.4% (n=2) of the necks treated with sharp dissection and in 4% (n=1) of the necks treated with cautery. There was no statistically significant difference between the two groups with respect to IJV thrombosis. Late Doppler examinations showed complete recanalization of all thrombosed IJVs.
Our data suggest that sharp dissection or cautery techniques performed in functional neck dissections do not differ with respect to the frequency of postoperative IJV thrombosis.
颈内静脉(IJV)血栓形成是功能性和选择性颈清扫术的一种罕见并发症。它会增加发病率,且很少会致命。我们调查了颈内静脉血栓形成的发生率及其与手术技术的关系。
我们评估了34例男性头颈癌患者(平均年龄57岁;范围34至76岁)所进行的52例功能性和选择性颈清扫术。手术主要采用锐性分离(n = 27)或电灼(n = 25)。术前、术后两周以及术后3至6个月,通过多普勒超声检查患者的颈内静脉血流及血栓形成情况。
术后早期,采用锐性分离治疗的颈部中有7.4%(n = 2)出现血栓形成,采用电灼治疗的颈部中有4%(n = 1)出现血栓形成。两组在颈内静脉血栓形成方面无统计学显著差异。后期多普勒检查显示,所有血栓形成的颈内静脉均完全再通。
我们的数据表明,功能性颈清扫术中采用的锐性分离或电灼技术在术后颈内静脉血栓形成发生率方面并无差异。