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不同类型选择性颈清扫术后的发病率。

Postoperative morbidity after different types of selective neck dissection.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Philipp University, Deutschhausstrasse 3, 35037 Marburg, Germany.

出版信息

Laryngoscope. 2010 May;120(5):924-9. doi: 10.1002/lary.20894.


DOI:10.1002/lary.20894
PMID:20222021
Abstract

OBJECTIVES/HYPOTHESIS: Although selective neck dissection (SND) is an oncologically efficient procedure for the N0 neck, its functional results are discussed controversially. The aim of the present study was to analyze the frequency of morbidity related to SND. STUDY DESIGN: Retrospective single-institution series. METHODS: The clinical data of 98 patients who had undergone unilateral SND of different dimensions and neck levels were analyzed. Radiotherapy was carried out in 37 (37.8%) patients. Functional and aesthetic results were evaluated in the context of aftercare consultation in 52 patients. The contralateral side of each patient served as the control. The mean follow-up period was 2.6 (0.5-9.1) years. RESULTS: SND-related complications arose in two out of 50 patients (4%) with dissection of level IV in terms of an injury of the thoracic duct. Ten (19.2%) patients showed persistent slight lymph edema, and 34 (65.4%) patients noticed cervical incision sensibility disturbances after at least 6 months. Concerning head, neck, and shoulder function, no significant side differences were noticed by 31 (82%) patients for arm abduction, 32 (84%) for head rotation, and 30 (79%) for lateral head inclination. Subjectively, 50 (96.2%) patients had no restriction in head, neck, and shoulder movement after SND. Concerning the aesthetic results, only one (2%) patient was subjectively not satisfied. CONCLUSIONS: SND of different dimensions and neck levels shows low incidence of surgical complications and acceptable functional and aesthetic results.

摘要

目的/假设:虽然选择性颈清扫术(SND)对 N0 颈部是一种有效的肿瘤学方法,但它的功能结果存在争议。本研究的目的是分析与 SND 相关的发病率。

研究设计:回顾性单机构系列研究。

方法:分析了 98 例接受不同层面和颈部水平单侧 SND 的患者的临床数据。37 例(37.8%)患者接受了放射治疗。在 52 例患者的随访咨询中评估了功能和美容结果。每位患者的对侧作为对照。平均随访时间为 2.6(0.5-9.1)年。

结果:在 50 例(4%)行 IV 水平清扫的患者中,有 2 例(4%)出现了胸导管损伤的 SND 相关并发症。10 例(19.2%)患者出现持续性轻微淋巴水肿,34 例(65.4%)患者在至少 6 个月后出现颈部切口感觉障碍。在头、颈、肩功能方面,31 例(82%)患者对臂外展、32 例(84%)患者对头部旋转、30 例(79%)患者对头部侧倾无明显侧别差异。主观上,50 例(96.2%)患者在 SND 后头部、颈部和肩部活动无受限。在美容结果方面,只有 1 例(2%)患者主观上不满意。

结论:不同层面和颈部水平的 SND 手术并发症发生率低,功能和美容效果可接受。

相似文献

[1]
Postoperative morbidity after different types of selective neck dissection.

Laryngoscope. 2010-5

[2]
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Arch Otolaryngol Head Neck Surg. 2006-1

[3]
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[4]
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[9]
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Zhonghua Kou Qiang Yi Xue Za Zhi. 2006-5

[10]
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