颈清扫术中保留颌下腺的可行性：一项前瞻性解剖病理学研究。
Feasibility of submandibular gland preservation in neck dissection: A prospective anatomic-pathologic study.
机构信息
Division of Otolaryngology - Head & Neck Surgery, Simmons Cancer Institute at Southern Illinois University, Springfield, Illinois.
出版信息
Head Neck. 2011 May;33(5):603-9. doi: 10.1002/hed.21499. Epub 2010 Aug 24.
BACKGROUND
The submandibular gland is commonly removed during neck dissection involving sublevel IB. However, removal reduces basal salivary secretion and therapeutic options for minimizing xerostomia. The purpose of this study was to determine whether all lymph nodes in sublevel IB can be extirpated without removing the submandibular gland.
METHODS
Twenty consecutive patients undergoing 33 neck dissections were prospectively enrolled. Sublevel IB dissection was performed by 3 sequential steps: (1) removal of targeted lymph node groups (preglandular and postglandular, prevascular and postvascular), (2) removal of submandibular gland, and (3) removal of residual lymphoadipose tissue in the surgical bed.
RESULTS
Complete removal of lymph nodes in sublevel IB was achieved before excising the submandibular gland in all of the 30 eligible neck dissections. The submandibular gland and the surgical bed contained no residual lymph nodes.
CONCLUSION
In suitable cases, it is technically feasible to remove all lymph nodes in sublevel IB and preserve the submandibular gland.
背景
在涉及 IIB 亚区的颈部解剖中，通常会切除下颌下腺。然而，这种切除会减少基础唾液分泌，并限制了减少口干的治疗选择。本研究的目的是确定是否可以在不切除下颌下腺的情况下彻底清除 IIB 亚区的所有淋巴结。
方法
连续 20 例患者共 33 例颈部解剖患者前瞻性纳入本研究。通过 3 个连续步骤进行 IIB 亚区解剖：（1）切除目标淋巴结群（腺前和腺后、血管前和血管后）；（2）切除下颌下腺；（3）切除手术床中剩余的淋巴脂肪组织。
结果
在 30 例符合条件的颈部解剖中，所有患者在切除下颌下腺之前均成功彻底清除了 IIB 亚区的淋巴结。下颌下腺和手术床内无残留淋巴结。
结论
在合适的情况下，技术上可以彻底清除 IIB 亚区的所有淋巴结并保留下颌下腺。
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