Badellino F, Margarino G, Scala M, Galli A, Mereu P, Gipponi M
Divisione di Oncologia Chirurgica, Istituto Nazionale per la Ricerca sul Cancro, Genova.
Minerva Med. 1990 Oct;81(10):673-8.
The role of surgery in head and neck cancer treatment is now well established, as it appears the most effective approach to such patients, while other therapies (i.e. chemotherapy, radiotherapy) can be of some help as second choice procedures. Surgery demonstrates however its own pitfalls, as it can often cause secondary anatomo-functional defects. The main problems appear to be related to the impossibility of physiological feeding following composite resection for oral cancer. An immediate reconstruction by transposition of myocutaneous flaps is of the utmost importance, as it reestablishes the preoperative condition lessening hospitalization time and postoperative disabilities. Neurological lesions, an unfrequent major complication of cervical lymphadenectomy, can cover a wide range of seriousness, from hardly detectable sensorial deficits to the impossibility of spontaneous ventilation. In this paper the Authors, on the basis of their experience, describe the measures to be taken in order to avoid secondary lesions (or to minimize their effects) in head and neck cancer surgery.
手术在头颈癌治疗中的作用现已得到充分确立，因为它似乎是针对此类患者的最有效方法，而其他疗法（即化疗、放疗）作为第二选择的程序可能会有所帮助。然而，手术也有其自身的缺陷，因为它常常会导致继发性解剖功能缺陷。主要问题似乎与口腔癌复合切除术后无法进行生理性进食有关。通过肌皮瓣转移进行即刻重建至关重要，因为它能恢复术前状态，减少住院时间和术后残疾。神经损伤是颈淋巴结清扫术罕见的主要并发症，其严重程度范围广泛，从几乎难以察觉的感觉缺陷到无法自主通气。在本文中，作者根据他们的经验，描述了在头颈癌手术中为避免继发性损伤（或使其影响最小化）而应采取的措施。
