Kobayashi S, Miyakawa M, Sugenoya A, Yokozawa T, Senga O, Kaneko G, Kasuga Y, Iida F, Kobayashi S, Takemae N
Second Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Jpn J Surg. 1988 Sep;18(5):592-4. doi: 10.1007/BF02471495.
A case of a patient who required reconstruction of the carotid artery during a radical operation for advanced thyroid cancer is reported herein. The patient, a 64-year-old female who had had three previous operations for thyroid cancer, underwent a two-stage operation. In the first stage, the left cervical lymphnodes were dissected, but as a large metastatic node invading the left carotid artery could not be completely removed, some carcinoma tissue was left attached to the wall of the artery. The second stage involved a temporary shunt being set up between the common carotid artery and the internal carotid artery following heparinization, after which the invaded portion was resected, and the defect patched with a saphenous vein graft. Monitoring with a Doppler flow-meter and EEG were conducted throughout the operation. At present, cancer has recurred in the left submandibular and supraclavicular regions.
本文报道了一例晚期甲状腺癌根治手术中需要重建颈动脉的患者病例。该患者为64岁女性，此前曾接受过三次甲状腺癌手术，此次接受了两阶段手术。第一阶段，对左侧颈部淋巴结进行了清扫，但由于一个侵犯左侧颈动脉的大转移淋巴结无法完全切除，动脉壁上残留了一些癌组织。第二阶段，在肝素化后，在颈总动脉和颈内动脉之间建立了临时分流，然后切除受侵部分，并用大隐静脉移植物修补缺损。整个手术过程中使用多普勒流量计和脑电图进行监测。目前，左侧下颌下和锁骨上区域已出现癌症复发。
