Dua Anahita, Desai Sapan S
Center for Translational Injury Research (CeTIR), Department of Surgery, University of Texas-Houston, Houston, TX, USA.
Vascular. 2014 Apr;22(2):81-4. doi: 10.1177/1708538113476024. Epub 2013 May 13.
The benefits to modified radical neck dissection (MRND) are established but the procedure involves substantial neck dissection with occasional resection of the internal jugular vein (IJV). Loss of the IJV is associated with morbidity including increased cerebral edema, stroke, laryngeal edema, blindness, facial fullness, and dural thrombosis. This paper discusses the morbidity associated with MRND, especially regarding venous outflow concerns and technical approaches to IJV reconstruction. Patients who have previously undergone MRND may benefit from immediate reconstruction and/or reanastomosis of the IJV. An attempt to maintain at least one major functional venous drainage point for the head and neck is indicated to minimize the significant morbidity and mortality of bilateral loss of the IJVs. The Katsuno classification system of type A, B, and C IJV reconstruction methods, and the novel type K reconstruction, are discussed as methods of maintaining venous outflow from the head and neck.
改良根治性颈清扫术（MRND）的益处已得到证实，但该手术涉及广泛的颈部清扫，偶尔还需切除颈内静脉（IJV）。颈内静脉的缺失与多种并发症相关，包括脑水肿加重、中风、喉水肿、失明、面部肿胀和硬脑膜血栓形成。本文讨论了与改良根治性颈清扫术相关的并发症，特别是关于静脉流出道问题以及颈内静脉重建的技术方法。先前接受过改良根治性颈清扫术的患者可能会从颈内静脉的即刻重建和/或重新吻合中获益。为尽量减少双侧颈内静脉缺失导致的显著并发症和死亡率，应尝试保留至少一个头颈部主要功能性静脉引流点。文中讨论了A、B、C型颈内静脉重建方法的胜野分类系统以及新型K型重建方法，作为维持头颈部静脉流出的方法。
